A mental health trust where patients have been punished with a dangerous form of restraint faces being put into special measures. Inspectors found serious problems at the body that oversees mental health services in Norfolk and Suffolk. These included patients being held in the face-down prone position and being put in seclusion as a punishment. The prone position involves two or more staff holding a patient face-down on the floor and pinning down their arms, legs and torso. It can result in compression of the chest and airways and can be fatal. The Norvic Clinic - which is run by Norfolk and Suffolk NHS Foundation Trust - was singled out for its use of the 'prone' position in a report which found the trust 'inadequate' overall . Last April, Lib Dem care minister Norman Lamb announced controls banning its deliberate use on patients. The Norfolk and Suffolk Trust’s secure unit had been told to review its procedures after 38-year-old patient David Bennett died while being held in the prone position for almost 25 minutes in October 1998. A 2003 inquiry into the incident led by Sir John Blofeld found prone position restraints were ‘always dangerous’ and should never be used for more than three minutes. But a damning report into the trust released yesterday by the Care Quality Commission revealed prone restraints were not only still being carried out at the trust’s secure unit, they were being used as punishments. The report said: ‘Some patients told us that restraint and seclusion were used too frequently at the Norvic Clinic. ‘We were concerned about the high levels of face down (prone) restraint and that there was a punitive attitude towards patients. We observed that some episodes of restraint and seclusion may have been punitive. ‘While on the unit we saw that people who became violent were restrained and removed to the seclusion ward. Five people told us that they had been restrained and secluded following refusal to follow staff instructions. One person told us that if you do not sit correctly on the chairs you could end up being restrained and secluded.’ The Norfolk and Suffolk Trust’s secure unit was told to review its procedures after 38-year-old patient David Bennett died while being held in the prone position for almost 25 minutes in October 1998 . In its report, the CQC said it was unacceptable that patients who were secluded did not always have access to toilets and had to use a urine bottle or bedpan. Inspectors expressed concern that ‘high numbers’ of prone restraints being used at the trust’s acute and psychiatric intensive care wards, as well as its two centres for adults with learning difficulties. Nearly a third of all incidents where patients were restrained involved prone positions. The report stated: ‘We found there was not a safe, effective or responsive service at this trust and the board needs to take urgent action to address areas of inadequacy.’ It revealed there was a widespread problem with staffing shortages and a lack of training. The CQC suggested the trust’s problems were the fault of senior management, saying there was ‘a lack of leadership, support and awareness’ in some areas. But it praised frontline staff for being ‘kind and caring’ and rated the trust as ‘good’ in the care category. It was rated ‘inadequate’ overall however and the CQC has recommended to health services regulator Monitor that it go into special measures. In a statement, the trust said it accepted the findings and ‘vowed to put patients and staff first’ under a management team which had seen ‘extensive changes’. Deputy director of nursing Michele Allott said the trust was implementing Department of Health guidelines on restraint. She added: ‘The Norvic Clinic is a secure unit that looks after mentally disordered violent offenders deemed to pose a risk of serious harm to the public. ‘The guidelines are clear that there must be no planned restraint of a person in a prone position and we are reviewing and improving all of our training to help staff make better use of positive behavioural support, de-escalation and prevention strategies. ‘Restraint of a patient is only used as an absolute last resort where all other interventions have been exhausted.’
Norfolk and Suffolk NHS Foundation Trust rated 'inadequate' by watchdog .
Care Quality Commission found a host of failings during October visit .
These included the overuse of the 'prone' position to restrain patients .
The trust was told to review its use after death of David Bennett in 1998 .
Bennett, 38, died after being held in position for almost 25 minutes .
Report also reveals some patients in seclusion had no access to toilets .
A mental health trust where patients have been punished with a dangerous form of restraint faces being put into special measures. Inspectors found serious problems at the body that oversees mental health services in Norfolk and Suffolk. These included patients being held in the face-down prone position and being put in seclusion as a punishment. The prone position involves two or more staff holding a patient face-down on the floor and pinning down their arms, legs and torso. It can result in compression of the chest and airways and can be fatal. The Norvic Clinic - which is run by Norfolk and Suffolk NHS Foundation Trust - was singled out for its use of the 'prone' position in a report which found the trust 'inadequate' overall . Last April, Lib Dem care minister Norman Lamb announced controls banning its deliberate use on patients. The Norfolk and Suffolk Trust’s secure unit had been told to review its procedures after 38-year-old patient David Bennett died while being held in the prone position for almost 25 minutes in October 1998. A 2003 inquiry into the incident led by Sir John Blofeld found prone position restraints were ‘always dangerous’ and should never be used for more than three minutes. But a damning report into the trust released yesterday by the Care Quality Commission revealed prone restraints were not only still being carried out at the trust’s secure unit, they were being used as punishments. The report said: ‘Some patients told us that restraint and seclusion were used too frequently at the Norvic Clinic. ‘We were concerned about the high levels of face down (prone) restraint and that there was a punitive attitude towards patients. We observed that some episodes of restraint and seclusion may have been punitive. ‘While on the unit we saw that people who became violent were restrained and removed to the seclusion ward. Five people told us that they had been restrained and secluded following refusal to follow staff instructions. One person told us that if you do not sit correctly on the chairs you could end up being restrained and secluded.’ The Norfolk and Suffolk Trust’s secure unit was told to review its procedures after 38-year-old patient David Bennett died while being held in the prone position for almost 25 minutes in October 1998 . In its report, the CQC said it was unacceptable that patients who were secluded did not always have access to toilets and had to use a urine bottle or bedpan. Inspectors expressed concern that ‘high numbers’ of prone restraints being used at the trust’s acute and psychiatric intensive care wards, as well as its two centres for adults with learning difficulties. Nearly a third of all incidents where patients were restrained involved prone positions. The report stated: ‘We found there was not a safe, effective or responsive service at this trust and the board needs to take urgent action to address areas of inadequacy.’ It revealed there was a widespread problem with staffing shortages and a lack of training. The CQC suggested the trust’s problems were the fault of senior management, saying there was ‘a lack of leadership, support and awareness’ in some areas. But it praised frontline staff for being ‘kind and caring’ and rated the trust as ‘good’ in the care category. It was rated ‘inadequate’ overall however and the CQC has recommended to health services regulator Monitor that it go into special measures. In a statement, the trust said it accepted the findings and ‘vowed to put patients and staff first’ under a management team which had seen ‘extensive changes’. Deputy director of nursing Michele Allott said the trust was implementing Department of Health guidelines on restraint. She added: ‘The Norvic Clinic is a secure unit that looks after mentally disordered violent offenders deemed to pose a risk of serious harm to the public. ‘The guidelines are clear that there must be no planned restraint of a person in a prone position and we are reviewing and improving all of our training to help staff make better use of positive behavioural support, de-escalation and prevention strategies. ‘Restraint of a patient is only used as an absolute last resort where all other interventions have been exhausted.’
included patients being held in the face-down prone position and being put in seclusion as a which is run by Norfolk and Suffolk NHS Foundation Trust - was singled out for its use of patient David Bennett died while being held in the prone position for almost 25 minutes in by the Care Quality Commission revealed prone unit was told to review its procedures after secluded did not always have access to toilets care category. It was rated ‘inadequate’ overall