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CQC puts mental health trust back in special measures

Norfolk and Suffolk NHS Foundation Trust again rated inadequate overall in CQC inspection

Louise Prime

Friday, 13 October 2017

Norfolk and Suffolk NHS Foundation Trust has been placed in to special measures for a second time following a Care Quality Commission (CQC) inspection, the regulator announced this morning. The trust, which provides mental health, substance misuse and learning disability services across the two counties, said the CQC had also pointed out how caring and supportive its staff were – but it acknowledged that it had not made enough significant improvements over the past year, and promised to continue to improve at greater pace.

Following the CQC’s inspection in October 2014 it rated the trust as inadequate overall and placed it into special measures, but the trust was allowed to exit special measures after inspectors noted sufficient improvements when they returned last year. However, on a further inspection this July the CQC found the trust had not maintained standards and significant improvements were required – and again rated it as ‘inadequate’ overall, as well as ‘inadequate’ for whether services are safe and well-led; ‘requires improvement’ for whether services are effective and responsive; and ‘good’ for whether services are caring.

Inspectors on this latest inspection did find examples of good practice at the trust, including sensitive handling of difficult issues, with staff who understood individual needs of patients and showed ‘exceptional care and respect’ for a distressed patient; embedding of the peer support worker role into community teams and trialling of a new ‘peer support navigator’ role to prepare patients for discharge and help reintegrate them back into their local community; and further development of a centre that provided a therapeutic education service for young people who might otherwise be placed in schools out of area.

However, inspectors said the trust must make improvements in many areas, including:

  • Act to remove ligature anchor points and to mitigate risks where there are poor lines of sight.
  • Manage seclusion and restraint within the safeguards of national guidance and the Mental Health Act Code of Practice.
  • Ensure sufficient numbers of staff are available at all times, and that all relevant staff have completed appropriate training, particularly in suicide prevention and life support.
  • Ensure all risk assessments, crisis plans and care plans are in place, update and reflect the full and meaningful involvement of patients.

CQC’s chief inspector of hospitals, Ted Baker, said: “It is extremely disappointing that, on our return to Norfolk and Suffolk NHS Foundation Trust we found the board had failed to address a number of serious concerns; some of which we first reported on in 2014 …

“The trust board had not taken the action required to ensure that all its wards were safe environments for patient care, that clinical teams had a sufficient number of staff or that staff assessed and managed risk adequately. People did not always receive the right care at the right time due to a shortage of beds and sometimes people had been moved, discharged early or managed within an inappropriate service.”

He added: “The trust leadership, including the new interim chief executive, must ensure it takes robust action to ensure improvements are made and we will continue to monitor the trust closely.”

The trust’s chief executive Julie Cave responded: “In short, we have not made enough significant improvements over the past year and that has resulted in this retrograde step in our CQC ratings and in our progress.”

But she added: “Today’s report does not mean we have made no improvements. The CQC report also comments on how caring our staff are, stating that patients told them they felt ‘genuinely cared for’ and ‘supported’; that they ‘felt safe on our wards’; and that our community staff were ‘responsive to their needs, caring and treated them politely’.”

She concluded: “Our Board will remain focused … We will continue to improve but we will do so with greater pace in order to deliver the quality of service that the people of Norfolk and Suffolk deserve.”

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