Patients given mood-altering drugs without legal authorisation, says watchdog

Patients at a hospital in Paisley were given psychotropic medication without legal authority, according to a report by the Mental Welfare Commission.

Psychotropic drugs can affect how the brain works, causing changes in mood, awareness, thoughts, feelings, or behaviour and are used to treat some mental health conditions.

Staff at the Arran Ward at Dykebar Hospital were criticised in the commission’s latest annual inspection after certificates authorising treatment under the Mental Health Act were found to not correspond to the medication being prescribed.

This meant there were instances where psychotropic medication was being given without the legal authority to do so.

Other certificates, including ones providing consent to treatment, were found to not be in place where required, despite recommendations made by the commissioner last year to organise them better.

Inspectors also found that advance statements, which are written by someone who has been mentally unwell in which they set out the care and treatment they would like, or would not like, if they become ill again in future, were not being encouraged.

They made a recommendation last year to promote them, but said on speaking with ward staff recently, it remains unclear as to which patients have them and which do not.

Arran Ward is an inpatient, mental health unit which provides eight rehabilitation beds and 12 recovery beds.

The report made four recommendations in total, including asking managers and medical staff to ensure that all psychotropic medication is legally and appropriately authorised and a system of regular auditing compliance with this should be put in place.

It also urged managers at the ward to consider changing dormitories to individual rooms, which inspectors had previously recommended.

The report said: “Many inpatient areas across NHS Greater Glasgow and Clyde have been refurbished to provide patients with individual rooms and we continue to strongly encourage managers to consider the same for Arran Ward to ensure privacy and to protect the dignity of the patient.

“This is especially significant given the fact that many of this particular group of patients in the recovery part of the ward can be in hospital for fairly lengthy periods of time.”

In response, a spokesman at NHS Greater Glasgow and Clyde, which oversees the ward, said: “We acknowledge the finding that, in a few cases, certificates authorising treatment were inaccurate or not in place at the time of the commission’s visit in May, and have already taken appropriate action to rectify this.

“We have also put in place a system of regular auditing compliance with this as part of an action plan to address all the commission’s recommendations.”

The spokesman also commented on the report’s more positive feedback, which including patients speaking favourably about their care on the ward and that the commission recognised that care plans are patient-centred and recovery focussed.

Every year, the Mental Welfare Commission visits about 100 wards and units for people with mental ill health, learning disability, dementia or related conditions in Scotland, talking to patients, relatives and staff, and examining records.

Arran Ward was one of six wards whose report was released on Wednesday.

The others were: Ward 4 at Dr Gray’s Hospital in Elgin; Ward 4 at Forth Valley Royal Hospital; Brucklay Ward at Fraserburgh Hospital; Bruar Ward at New Craigs Hospital, Inverness; and the Robert Fergusson Unit at Royal Edinburgh Hospital.

Claire Lamza, executive director (nursing) of the Mental Welfare Commission, said there is “much to commend” in the reports, but added: “We have, however, also made some recommendations for improvement, including ensuring that staff training is updated to support staff in their roles, and ensuring that there are accurate records of care and treatment to both support those receiving care and treatment and those delivering it.”