- Independent mental health service
St Andrews Healthcare Northampton
We have taken urgent enforcement action by imposing a condition on St Andrew's Healthcare's registration on 14 July 2025 to keep service users safe by restricting new admissions at St Andrew's Healthcare Northampton. We have also imposed a number of conditions on St Andrew's Healthcare registration on 10 November 2025 to require the provider to make improvements in the safety and quality of care provided relating to; staffing, ward environments, blanket restrictions, risk management, observations, incident management, governance and systems and processes.
Report from 21 September 2025 assessment
Contents
Ratings - Forensic inpatient or secure wards
Our view of the service
This assessment of forensic inpatient or secure wards at St Andrew’s Healthcare Northampton took place between 10 and 29 October 2025. This was an unannounced inspection due to the significant concerns raised by CQC and partner agencies during our previous inspection. The service was taking action to address concerns identified, which included an independent review of the culture of the hospital. Additionally, the service had undertaken individual patient safety interviews with all patients across the site. Further to our previous inspection, the service was required to undertake regular reviews of incidents involving restraint. This included a review of incidents via review of CCTV footage. The service had also focussed on staff training and awareness in relation to closed cultures.
St. Andrews Healthcare Northampton is an independent hospital, run by St Andrews Healthcare limited, which is a registered charity. The charity provides specialist mental healthcare for patients who may have complex presentations, with challenging mental health needs. During our inspection we visited medium secure wards and a learning disability and autism services (LDA) ward.
An assessment has been undertaken of a specialist service that is used by autistic people or people with a learning disability. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the service guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities.’
This inspection was undertaken to determine if there had been any improvements further to our last inspection (in July and August 2025) and to identify progress against the service’s action plan and the sustainability of improvements made.
We visited 5 medium secure wards in the medium secure division, plus 4 secure learning disability/autism (LDA) wards. The wards visited were as follows:
- Fairbairn ward: a medium secure service for deaf men with 17 beds
- Robinson ward: A secure admission ward for adult males with a mental health diagnosis with 17 beds
- Mackaness Ward: A secure admission ward for adult males with a mental health diagnosis with 15 beds
- Cranford Ward: a medium secure service for older men aged over 55 years old with 17 beds
- Meadow ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
- Sycamore ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
- Marsh ward: A specialist medium secure admission, stabilisation and treatment service for men with a forensic history with distressed behaviour
- Oak ward: a recovery-orientated medium secure service for women aged over 18 with 10 beds
- Fern ward: A stabilisation and treatment secure service for men who may also have a forensic history with distressed behaviour with 10 beds
During this inspection we reviewed 14 quality statements under 3 key questions (safe, caring and well-led). We found ongoing breaches in relation to Regulation 12: Safe Care and Treatment; Regulation 13: Safeguarding service users from abuse and improper treatment; Regulation 10: Dignity and Respect ; Regulation 18 (staffing).
We will publish this information on our website after any representations and/ or appeals have been concluded.
In instances where CQC have decided to take civil or criminal enforcement action against a service, we will publish this information on our website after any representations and/ or appeals have been concluded.
Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
Staff were trained in and had a good understanding of the Mental Health Act (MHA), the Code of Practice and the guiding principles. As of September 2025, 95% of staff on medium secure wards, and 94% of staff on LDA wards were up to date with their Mental Health Act training.
Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice. Patients had easy access to information about independent mental health advocacy. However, the service had changed their advocacy service. Staff told us that access to independent advocacy had decreased.
Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded they had done it. Due to available staffing, staff were not able to ensure that patients were always able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.
Staff requested an opinion from a second opinion appointed doctor when necessary. Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly and so they were available to all staff that needed access to them.
Staff did regular audits to ensure the Mental Health Act was being applied correctly and there was evidence of learning from those audits.
Mental Capacity Act
Ninety five percent of staff in the learning disability and autism (LDA) and medium secure wards were up to date with their training in the Mental Capacity Act. Staff generally had a good understanding of the Mental Capacity Act, particularly the five statutory principles.
The service had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it. Staff knew where to get advice from within the service regarding the Mental Capacity Act, including deprivation of liberty safeguards.
Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff had assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis regarding significant decisions.
When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. The service had arrangements to monitor adherence to the Mental Capacity Act.
People's experience of this service
During this inspection, we spoke with 33 patients. There was a wide range of views raised by patients. The highest concern was raised by 13 patients, who told us that there were not enough staff on the wards. One patient told us that there were “not enough staff to stop fighting, adding that “something dreadful might happen”. Seven patients spoke about leave and activities being cancelled and another 2 patients told us there was nothing going on in the ward. One patient told us there were not enough staff to take them out, that leave had to be pre-planned and staff were only able to facilitate patient leave in the morning. Patients told us this was due to the nursing team needing to facilitate staff breaks. Another patient told an inspector that there are more staff when the CQC are here, adding that “often there isn’t a nurse in the day area or bedroom corridor”, a view which was endorsed by another patient.
Nine patients were not happy on the wards. Four patients felt that things were getting worse, 6 patients spoke about the poor standard of food and size of food portions, and 9 patients spoke about the attitude of some staff including ‘being ignored by staff’. One patient told us that you ‘could count the nice nurses on one hand”.
However, this was not a view shared by all patients. Four patients told us that the ward was good, and a further 4 told us that the nurses were nice. Five patients raised concerns about the number of staff who had been assaulted by patients and a further 3 patients told us that staff were being racially abused.