Firshill Rise: Sheffield NHS unit where staff neglected vulnerable patients remains closed

Reports to an upcoming meeting of Sheffield City Council’s health scrutiny sub-committee on Thursday (March 23) are looking at what has been learned from the serious failures found at Firshill Rise, a seven-bed NHS assessment and treatment unit for people with learning disabilities who also have mental health and behavioural issues.

A Care Quality Commission (CQC) inspection in 2021 banned the admission of new patients without written permission from the CQC following an inspectors’ report. It said that “the service was not safe with concerns about staffing skills and training, medications management and safeguarding”, said a report to the committee.

The CQC inspectors found that staff ignored patients’ requests for food and drink, staff were not trained in how to safeguard patients from abuse, management systems were poor, patients and relatives were not involved in care planning and patients stayed too long on the unit.

An NHS review found that one patient had been on the unit for two years – the expected length of stay would be around six months.

A report to the council committee says that Firshill Rise was closed temporarily in 2021 due to the concerns. It has remained closed during a period of quality review, but also because there are difficulties in recruiting specialist staff to reopen the service.

Safeguarding

“There have been a number of national high-profile institutional failures regarding in-patient and residential services including Whorlton Hall and Winterbourne,” a report says. “The response to these serious issues has informed the Sheffield Health and Social Care Foundation NHS Trust’s response to the failures at the ATS (Firshill Rise).”

The NHS trust apologised for the failures and a review took place of the leadership of the learning disability service.

Improvements put in place include new leadership structures, better training, safeguarding procedures, increased scrutiny and whistleblowing policies. Tougher controls have been brought in for restrictive practices and segregation of patients, and regular visits by patient advocates put in place.

An overhaul in the way that in-patient care is organised for people who would have come to the unit also meant that demand for beds at Firshill Rise has dropped to zero.

The committee will hear that a new focus for health services for adults with a learning disability will include moving away from long in-patient stays towards the “least restrictive environments closest to home” and discharging patients more quickly.

Currently, there is only one person with a learning disability in in-patient care and one in secure care. Work is also taking place to reduce the need for people with learning disabilities to be placed in restrictive care.

Intervention

The NHS is developing better community-based services “to promote earlier intervention and prevention of crisis developing, when services and families struggle to manage behaviours that can be challenging to support in the community”, says a report to the committee.

New service plans will involve people with lived experience of being learning disability in-patients and their representatives, families and carers. The group Sheffield Voices has spoken to groups such as Sheffield Mencap & Gateway and run several events in the learning disability community alongside Healthwatch Sheffield.

More public consultation is planned.

The NHS is also looking at better care for people with autism only who have mental health conditions, who would not have gone to Firshill Rise.

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