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“Chaotic, scary and really, really intense” – Steph Smith’s time working at Huntercombe Hospital was nothing short of harrowing.
And as a former mental health patient at the scandal-hit site in Maidenhead, she is better placed than most to make a judgment.
At just 19 years old, with limited qualifications and after just 10 days of training, Ms Smith was often the most senior person available when serious incidents, such as patients self-harming, occurred at its Thames ward, where she was responsible for caring for its most acutely mentally unwell children and teenagers.
Months after Ms Smith started working there, 14-year-old patient, Ruth Szymankiewicz, fatally self-harmed after she was left alone by another care worker who had been given just a day and a half’s training and was working under a fake ID.
Now, speaking out for the first time in an exclusive interview with The Independent and Sky News, care worker Ms Smith and nurse Ellesha Brannigan have lifted the lid on their time working at the hospital to reveal the “chaotic” and understaffed working conditions on the ward where Ruth spent her tragic final days.
And former nursing director for the Huntercombe Group, Philip King, has also come forward to warn that the NHS and CQC should have closed the hospital, formerly known as Taplow Manor, years ago.
Having spent time at Huntercombe as a patient from June 2017 to March 2018 for treatment for post-traumatic stress disorder and self-harm, Ms Smith took up a role as a care worker at the hospital in November 2021 in the hope she could help others. But the reality was very different.
“It was chaotic. It was scary and really, really intense… we just seemed to be putting out fires constantly, and there was no real routine and nothing therapeutic… I didn’t receive any supervision or any sort of support from management while I was there.
“There would be an incident, and somehow I would be the most experienced person in the room, and I would think I’m 19 years old, I’ve been working here for just a couple of months.
“I hadn’t had previous work experience and nor did I really have any particular academic qualifications. In hindsight, I think it just demonstrates the real need for staff and the real desperation to hire anybody that would do it.”
During an inquest into Ruth’s death, former staff members revealed the hospital had chronic staffing problems and had half the number of staff it needed on the day she died. A jury concluded her death amounted to an “unlawful killing” because of a litany of care failures, including her not being monitored properly when she should have had constant care.
On 12 February 2022, Ruth was left alone by the care worker, known to the hospital as Ebo Achempong, for 15 minutes, during which time she made her way to her room, locked her door and self-harmed. She was resuscitated but tragically died two days later in the hospital.
Ms Smith said: “I was really shocked and devastated to hear of Ruth’s death, but there had been so many warning signs for so many years. We had had countless near misses, even in the time that I’d worked there, and I think back to when I was a patient, there were so many signs…
“I didn’t want to leave the young people in that situation, but I also just couldn’t be complicit in a system that was just so harmful and so damaging. It really broke my heart.”
On 12 February 2022, Ellesha Brannigan, a mental health nurse, clocked on for her shift on Thames Ward. Just hours later, Ruth was dead.
Speaking publicly for the first time after giving evidence at her inquest, Ms Brannigan told The Independent, that short staffing was a constant issue.
She said: “We were understaffed at the time, and it wasn’t always due to not being able to find staff either, we were just told these are the numbers that you have to work with and that’s that… Myself and other staff members had so many meetings with managers about this.”
Ms Brannigan said Thames Ward was her first job – and it was a daunting one.
“It was scary at times, it was stressful; it definitely took a toll on me; it was my first job, I didn’t know any different. But you don’t realise how bad it is until you leave and look back on what’s happened.”
Ms Brannigan said she had concerns not only about the agency staff, but also about their experience levels: “Some of the staff were that were being hired were 19 or 20 years old, and some of our patients were 16 or 17 years old. It just wasn’t right.”
Despite raising concerns, she said staff were not listened to by managers.
“If we didn’t have enough staff to cover the observation levels sometimes, they would suggest that we decrease some of the observation levels, and we would argue that we can’t just do that; it’s completely unsafe.”
“Sometimes we would have four or five kids having incidents at the same time. We didn’t have the staff to respond, so that becomes unsafe.”
A month after Ruth’s death, the Care Quality Commission (CQC) handed the hospital a warning notice and put it into special measures, meaning it required urgent improvement.
But Ms Brannigan said “things didn’t change after Ruth died”.
“I would’ve worried another child would have been harmed like Ruth. Taplow Manor is not an isolated incident.”
However, the mental health nurse added: “I worked with some of the most passionate, caring and empathetic staff who wanted to be there to make a difference to these kids’ lives, and I really would like that to be highlighted; they were not all bad. We were doing the best we could with the resources we were given.”
Philip King, a former nursing director for The Huntercombe Group, said he believed the hospital should have been closed years before Ruth’s death. He claims that NHS officials and the care watchdog, the CQC, knew about staff concerns but continued to place patients there.
Mr King, who worked at the organisation from 2018 to 2020, said: “If I were NHS England, I would have closed the service, given everything they knew at the time… where you are in a situation where you’re being told that these services are unsafe, I would not have continued to commission and place patients there.
“Children and young people are placed there because they are significantly at risk. To put them in a situation that places them at greater risk is unconscionable in my view.”
“The problems that were clearly at play around this young person’s care had been going on for, you know, years. They are systemic. The CQC were well aware of them. We can’t say that these things weren’t known about, and yet the provider collaborative and the broader in NHS continued to place patients there.”
Active Care Group (ACG), which ran the hospital at the time of Ruth’s death, closed it a year later in June 2023.
AGC said it acquired the remaining services of the Huntercombe Group in December 2021, and put “significant investment” in staff training, recruitment and the hospital estate.
ACG said it has achieved 100 per cent Good or Outstanding ratings from the CQC over the past 12 months.
