Concerns Over Safety At Essex Mental Health Trust

One of Essex's mental health trusts has been told it "requires improvement" in a report by the health watchdog.

North Essex Partnership

When the Care Quality Commissioner visited the North Essex Partnership NHS Foundation Trust last year it found a range of issues, particulary around patient safety.

CQC's Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said: "Our inspectors found the trust must make a number of improvements to bring its services overall up to a level that would earn a rating of Good overall. We gave immediate feedback to the trust following the inspection and this report presents the detail of our findings, our ratings and our recommendations.

"In particular, we were concerned that staff in some services were not always following best practice in assessing mental capacity and obtaining consent.

"They were also not involving the patient sufficiently in the planning of their care.

"Staff sometimes failed to make patients aware of their legal rights and there was a lack of occupational therapy or other specialised day activities.

"Trust managers took a long time to make improvements to services, including those necessary to assure that patients were safe.

"Changes took a long time to implement and consultations on improvements were not given the urgency necessary to give confidence that matters would be resolved.

"For example, they had identified the need to make changes to wards to remove fixtures and fittings that might put patients at risk but had had not yet undertaken the work.

"Ligature-free doors had not been installed or even commissioned despite these having been agreed some time ago.

"There were still an unacceptable number of ligature risks identified during the inspection.

"Over the past five years, CQC inspectors, along with Mental Health Act reviewers, have inspected this trust several times.

"Each time we have identified problems that the trust needed to address; for example regarding safety at both the Linden Centre and the Lakes locations.  

"Each time the trust had given assurances and then has not done so.

"Despite these concerns, we also found a number of areas of good practice across North Essex Partnership NHS Foundation Trust.

!The trust spent two years planning and consulting for the community transformation programme which started in April 2015. Patients confirmed that these changes had led to improved community mental health care and treatment delivery by the trust.

"We found some good examples of positive multidisciplinary work, met staff who were supporting patients well and heard positive feedback from patients and carers.  
 
"The trust leadership knows what it needs to do to bring about improvement in the areas identified and our inspectors will return at a later date to check on what progress has been made."

Chief Executive of the North Essex Partnership University NHS Foundation Trust (NEP), Andrew Geldard said: "While we are naturally disappointed at our overall rating, 'requires improvement', from the CQC, we have always viewed their inspection as a development opportunity, opening our services to external, expert scrutiny.  

"This was, indeed, our first comprehensive inspection by the CQC looking at our services as a whole.

"While much of the discussion around the report will focus on our in-patient adult wards, where the inspectors found issues regarding the quality of the environment, the range of activities for service users and care planning, we must remember they also reported many areas of good practice and received many positive comments about care from service users and carers.

"Indeed, more than 60% of their findings rated the Trust as 'Good' and one was 'Excellent.'

"However, the CQC's concerns are a call to action for the Trust and we have already begun a programme of improvements to our patient environment which will cost more than £1m.

"We have made changes to our care planning process to ensure it is focused on the individual and are improving the range and number of activities for patients. More work that addresses all the CQC's comments is either in progress or planned.  

"I would assure our patients and their families and friends that improving these areas are our overriding priority in the coming months.  

"While the process has been highly challenging, it has been very rewarding and has given us a clear direction to take across all our units. We are confident this will bring real benefits to patients and carers and provides the Trust with a strong base from which to move forward."

You can read the full report here: http://www.cqc.org.uk/provider/RRD

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