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6 December 2016, 09:32
An Essex mental health trust has been issued a warning after inspectors found concerns with ward environments.
The CQC said staff at North Essex Partnership University NHS Foundation Trust didn't always assess risks and that older people wards weren't complying with same sex accommodation requirements.
The report said: !We were concerned about the safety of some of the ward environments. Many of these were issues that we had raised at our last inspection. Staff did not always assess risks on wards or manage risk from ligature points well; including on wards with poor lines of sight.
"The Christopher unit and older people wards that admitted both men and women did not comply with the requirement to provide same-sex accommodation. The Christopher unit’s seclusion room did not meet the standards outlined in the Mental Health Act Code of Practice.
"Staff subjected patients to blanket restrictions on acute wards. The trust was not sharing learning from incidents effectively with staff and the trust’s incident reporting policy and procedures needed updating to reflect national guidance.
"The trust did not ensure wards were fully staffed as wards staffing shifts were unfilled due to staff sickness or leave; all wards had staffing vacancies, and were using bank and agency staff. The trust did not ensure that staff received clinical supervision and training regularly.
"The trust did not ensure a consistent approach to staff administration and storage of medication across acute and older people wards as we found gaps in staff records and problems with medication storage.
"Staff did not check the equipment and environment in line with trust policy. Refurbishment work and repairs were not always finished to a high standard.
"15% of patients’ records did not contain detailed information which included risks and they had not been updated regularly. Staff had recorded 26% of staff restraints on patients on these wards were in a prone position. The trust staff survey action plan did not detail how the trust was responding to the key issues from the 2015 results.
"However we found the following areas of good practice - 95% of patients gave positive feedback about the staff, and their experience of care on the wards. 87% of patients and 66% of carers said they were involved in discussions about their or their relatives care. Seven wards used ‘my care, my recovery’ booklets to capture this involvement. Staff and patients spoke positively about the restraint training staff used and said the new techniques made them feel safe and less fearful."
Responding to the report Christopher Butler, the Interim Chief Executive of the North Essex Partnership University NHS Foundation Trust said: "I am grateful to the CQC for the positive comments it has made about the improvements it has seen in the Trust. Since becoming the Interim Chief Executive of the Trust in March I am deeply impressed with the commitment of staff and the investments made in improving facilities. However, the CQC is right that there is much more to do, particularly consistency in providing services, and how the Trust has oversight of this.
"This is why our services are managed, and the way in which Board of the Trust understands work being done at the “front line” has been strengthened. These changes had been in place only 6 weeks before the unannounced inspection. The Board of the Trust is committed to seeing through the investments it continues to make in improving inpatient environments, ensuring consistency in its work, and helping people to support patients whilst holding people to account for their work."