Disabled man knocked himself unconscious in 'inadequate' hospital seclusion room

A health authority boss has apologised after a High Court judge said he was profoundly disturbed about the way in which a severely disabled man was kept in seclusion at a specialist unit.

Richard McKendrick, chief operating officer of Northamptonshire Healthcare NHS Foundation Trust, said he was very disappointed at the “unacceptable” quality of care the 25-year-old man had received at the Vale Hospital.

Mr Justice Hayden said the man had knocked himself unconscious while held in a seclusion room and a nursing expert had raised concerns about “inadequate” padding on a door.

The judge said he had been astonished to read emails questioning the necessity of additional padding “largely on the grounds of expense”.

He said the man’s father had also been astonished.

Detail has emerged in a written analysis of the case by Mr Justice Hayden following hearings in the Court of Protection in London.

The judge said the man could not be identified.

But he named Northamptonshire Healthcare NHS Foundation Trust as one of the health authorities involved – and he included Mr McKendrick’s apology in his analysis.

The Court of Protection is part of the High Court and judges analyse cases involving sick and vulnerable people.

Mr Justice Hayden said the man had been an inpatient at the Vale Hospital for about six months in 2012.

The judge said a document detailing the number of times the man had been held in seclusion was “very disturbing”.

He said records showed that the man had regularly been held in seclusion for periods of between 60 and 90 minutes and on one day had been kept in seclusion for five hours.

On one occasion the man had “knocked himself unconscious” while in seclusion, said the judge.

Mr Justice Hayden said a nursing expert, who had given evidence as part of the court investigation, had drawn the hospital’s attention to “what she considered to be inadequate padding to the door of the seclusion room”.

“I should have thought that anyone hearing her views on this particular issue would have responded immediately and with some alarm,” said Mr Justice Hayden.

“Astonishingly, and I do not use that word lightly, what followed was an email exchange that challenged the necessity of the additional padding largely on the grounds of expense.”

He added: “The fact of injury coupled with the frequency and the duration of some of the periods of seclusion is profoundly disturbing.

“The tardiness in responding to (the expert’s) concerns – the padding was eventually rectified – and the reasoning behind the delay is to, my mind, unjustifiable. (The man’s) safety and his dignity were avoidably compromised.”

Mr Justice Hayden said Mr McKendrick had apologised at one of the court hearings.

The judge said: “He told me from the witness box, ’hearing the evidence I share the concern expressed. I am very disappointed at the quality of care (the man) received at the Vale Hospital. I find it unacceptable. On behalf of the trust I apologise to the (the man’s) family for making mistakes and getting it wrong.

“’In my experience, listening to and reading the evidence we should have been more proactive from the first point of (the man’s) head banging to ensure the seclusion room was safe and properly padded....

“’The whole circumstances of (the man’s) admission falls far short of the standards our staff and services aim to provide. I can only say the staff acted with good intentions but made mistakes.

’“I apologise unreservedly on behalf of the trust.”’

The judge said Mr McKendrick had told the court that he would “take on board the lessons of this hearing to see that this does not happen again”.

Mr Justice Hayden added: “That fulsome apology was well judged and nothing less would have been appropriate.

“When I heard it I asked (the man’s father) for a response. He told me that he was ’astonished’. He accepted it with dignity, though he commented that it was too late to afford him any reassurance.”