Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust CQC report
Improvement needed in community-based mental health services
The Care Quality Commission (CQC) has told Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust they must make improvements after the rating for community-based mental health services for adults of working age has declined from outstanding to requires improvement, following an inspection from 25 to 27 February.
CQC carried out a short notice announced inspection due to receiving information of concern about the safety and quality of care being provided, as well as part of CQC’s continuous monitoring of services.
At this inspection, CQC found two breaches of regulation, one relating to staffing and the other regarding good governance.
CQC has told the trust to submit a plan showing what action it is taking in response to these concerns. CQC will continue to monitor the trust to ensure these improvements are made and people are safe while this happens.
Following this inspection, the overall rating for the service has declined from outstanding to requires improvement. Safe and well-led have dropped from good to requires improvement. How effective and caring the service is has gone down from outstanding to good, and responsive has been re-rated as good.
Victoria Marsden, CQC deputy director of operations in the north east, said:
“During our inspection of the trust’s community-based mental health services for adults of working age, we found a deterioration in the standard of care being delivered to people since our previous inspection. Leaders hadn’t created a culture where staff could deliver high quality, person centred care.
“It was concerning that staff didn’t always involve people in their care planning and risk assessments. Some of the care plans we looked at were either out of date, weren’t personalised or didn’t exist at all. This could put people at risk of harm if staff weren’t aware of their individual needs.
“Some people told us that they’d waited for up to two years to access the service. People had received an initial phone call, but they didn’t always find it helpful and still had to wait to access therapy sessions which they found frustrating.
“However, most people told us staff were discreet and respectful. They felt staff listened to their views and preferences, and explained their treatment in a way they understood.
“We’ll continue to monitor the service, including through future inspections, to make sure the trust has made the required improvements and people are receiving the safe care they deserve. We won’t hesitate to take further action if we find this isn’t happening.”
Inspectors also found:
• The trust did not share the learning from incidents with all staff, to help prevent them from happening again.
• Staff did not always explain to people their rights under the Mental Health Act in a way that they could understand.
• Staff were not always provided with the support, training and supervision required to care for people in a safe way.
• Staff were not always working in safe conditions, for example buildings where assessments were taking place, did not always have alarms if they needed urgent assistance.
• Staffing challenges contributed to significant delays in people being assessed for community treatment services. Teams were trying to address this by using agency staff and providing assessments at weekends.
However:
• Staff knew how to identify people at risk of, or suffering significant harm.
• All staff knew what incidents to report and how to report them.
• Staff understood the duty of candour. They were open and transparent, and gave people and families a full explanation if and when things went wrong.
The report will be published on the CQC website in the next few days.