Healthcare Inspectorate Wales (HIW) has reported significant concerns about patient safety and quality of care at the Royal Glamorgan Hospital in Llantrisant, following an unannounced inspection of its mental health services in April 2026. The inspection, conducted over three days, focused on wards 21, 22, and the psychiatric intensive care unit (PICU), which are managed by Cwm Taf Morgannwg University Health Board.
Positive Findings Amidst Serious Concerns
Inspectors noted that staff treated patients with kindness, respect, and compassion, and patients reported positive experiences of care. Strong clinical processes were observed, including thorough assessments, regular wellbeing reviews, and timely access to healthcare services. Care and treatment plans, as well as individual safety plans, were comprehensive and regularly reviewed. Effective processes supported safeguarding, care planning, and multidisciplinary team working.
However, the inspection also identified a range of significant concerns. HIW used its immediate assurance process to seek assurances from the health board regarding environmental, infection prevention and control, and workforce safety issues. These included damage to fixtures and fittings, infection risks, and unresolved ligature risks where patients could potentially harm themselves. Estates records highlighted multiple unresolved urgent and high-risk maintenance issues, alongside longstanding capacity pressures within estates services.
Training and Staffing Deficiencies
Inspectors found low compliance with key safety-critical mandatory training, including life support, restraint, moving and handling, and fire safety. Notably, no staff had completed training in the safe use of portable oxygen cylinders, and inspectors were unable to confirm whether untrained staff had been involved in restraint incidents. Similar concerns were identified during a previous HIW inspection in 2023, indicating that risks previously escalated had not been effectively mitigated or sustained over time. These findings reduced assurance that staff were consistently equipped to respond safely in high-risk situations.
Patient Experience and Environment
Patients reported difficulties accessing therapeutic activities, outdoor space, and some basic facilities. Inspectors found no structured programme of therapeutic activities across the wards, a vacant Activities Coordinator post, and no dedicated occupational therapy support for patients in the PICU. Issues relating to mixed gender accommodation and shared bedrooms on wards 21 and 22 continued to affect patient privacy, safety, and dignity.
Health Board Response and Ongoing Monitoring
HIW has set out clear expectations for improvement and will continue to monitor the health board's progress. Chief executive of HIW, Alun Jones, said: “Our inspection revealed that direct care is delivered by staff in a compassionate way with patients commenting positively on it. However, the health board has not sustained improvements previously made in relation to significant issues, and long‑standing estates and environmental risks remain. Whilst these are not isolated findings, and reflect issues we continue to see across mental health settings in Wales, we expect the health board to take sustained action to address these concerns and ensure patients receive safe, high‑quality care.”
A spokesperson for Cwm Taf Morgannwg University Health Board said: “The health board welcomes the findings from Healthcare Inspectorate Wales following its recent inspection of wards 21, 22 and the PICU at the Royal Glamorgan Hospital. The report reflects a number of strengths within our mental health services, and we were pleased that the Inspectorate recognised the delivery of safe, compassionate and effective care, alongside the positive experiences reported by patients. We acknowledge that there are areas where improvements are required. Where the Inspectorate identified issues requiring immediate assurance, prompt action was taken and action plans were implemented to address those concerns. It is encouraging to see that a number of the recommendations identified within the report have already been completed since the initial visit, and colleagues continue to work at pace to address the remaining areas, with a comprehensive improvement plan in place to support this activity. We remain committed to providing safe, effective and compassionate mental health care and will continue to work closely with staff, patients and partners to deliver the improvements identified in the report.”
