SUF provided our service user feedback report, called Making our Voice Count to the Care Quality Commission (CQC) ahead of their November 2020 inspection of NSFT. Our report identified an increase in positive feedback and service user/family carer evaluation of service quality but highlighted recurring problems which included difficulty accessing services, including the speed of response to people in crisis and continued problems with people being discharged from NSFT care, without fully being involved in their discharge plans.
On 22nd January 2021 The Care Quality Commission published its report on their focused inspection of NSFT’s mental health crisis services and health-based places of safety delivered by NSFT, including the new First Response Service. The Care Quality Commission (CQC) welcomed improvements in the two services run by Norfolk and Suffolk NHS Foundation Trust but emphasized that the trust must make more progress to ensure patient safety. Following the inspection, both services were rated Requires Improvement.
The CQC Press release states:
The Care Quality Commission (CQC) has welcomed improvements in two services run by Norfolk and Suffolk NHS Foundation Trust, following inspections it undertook in November 2020 – but the trust must make more progress to ensure patient safety.
CQC inspected the trust’s acute wards for working-aged adults, which provide psychiatric intensive care. It also inspected the trust’s mental health crisis services, where people who have been sectioned under the Mental Health Act receive initial assessment.
These services are provided from several of the trust’s locations including Hellesdon Hospital in Norwich, Northgate Hospital in Great Yarmouth and the Woodlands unit at Ipswich Hospital.
The inspection was undertaken in response to potential risks to patient safety, and to review progress with improvements that CQC had said were needed following its previous inspection of these services, which took place in October 2019.
The latest inspections found that the trust had made significant improvements in several areas, but further work was still needed to improve patient safety in these services.
Following the inspection, both services were rated Requires Improvement. They were also rated Requires Improvement after CQC’s previous inspection.
The inspection was not wide-ranging enough to update the trust’s overall rating. It remains Requires Improvement overall.
Stuart Dunn, CQC head of hospital inspection for mental and community health services, said:
“I welcome the improvements that have been made in the services that we assessed, but the trust has further work to do to ensure that these services meet standards that people should be able to expect.
“The services did not always manage risks well. This had led to patients self-harming on the trust’s acute wards for working-aged adults.
“Patients waited too long for assessment in its mental health crisis service, and staff in this service did not always maintain comprehensive records about people’s medication. This service’s care was impaired by a high number of vacancies.
“Both services should make better use of debriefings following incidents, such as when staff had restrained patients to prevent them from harming themselves and others. Learnings, identified through debriefings, should be shared across the organisation to help it improve.
“However, we saw a number of areas of improvement and new good practice – and it is clear the trust and members of its staff are working hard to maintain progress.
“Staff told us that they felt more listened to by the trust, and we saw evidence of an improving culture.
“Patient areas were clean and well equipped, and measures had been implemented to protect people from COVID-19.
“Staff knew how to protect people from abuse, and they told us that they felt empowered to speak up when they had concerns about issues that could affect people’s care and wellbeing.
“Following the inspection, we reported our findings to the trust. We continue to monitor it closely to ensure that patients receive safe and effective care and treatment.”
CQC has told the trust that it must make several improvements to meet its legal obligations in its health-based places of safety, including:
- Following systems and processes to safely prescribe, administer, record and store medicines
- Holding debriefings following incidents, and sharing outcomes and lessons learned with all staff
- Meeting referral-to-assessment targets
- Staffing the service adequately.
CQC has told the trust that it must make several improvements to meet its legal obligations in its acute wards for working-aged adults, including:
- Managing patient safety effectively
- Addressing patients’ physical healthcare needs, and ensuring staff complete relevant training to support this
- Applying governance processes consistently across all wards.
Diane Hull, chief nurse at NSFT said:
“We’re pleased the CQC recognised the efforts of our hardworking staff and recognised improvements in several areas, including the positive steps being taken by our crisis teams to support our local hospitals’ emergency departments, and how our partnership working is ensuring people receive the right help when they experience a mental health crisis.
“We also recognise the challenges in the report and have put actions in place to address the CQC’s concerns, including increasing staffing in our First Response service, recruiting staff to specifically support a reduction of self-harm, and we will soon opening an additional 20 beds for older adults in Norwich.”
(Quotation link – https://www.nsft.nhs.uk/Pages/CQCreports.aspx).