The Care Quality Commission (CQC) has published a report following an inspection at Black Country Healthcare NHS Foundation Trust.
A focused inspection was carried out at the trust’s acute wards for adults of working age and psychiatric intensive care unit (PICU), following concerns raised with the commission about the quality of care, staff attitudes and engagement with patients.
During the inspection, concerns were found regarding the care and safety of people using the service. CQC asked the trust to provide an action plan detailing how it would make improvements.
Following the inspection, the rating for acute wards for adults of working age and the PICU remains requires improvement. The trust’s overall rating remains unchanged as good.
Jenny Wilkes, CQC head of inspection for mental health and community services, said:
“When inspectors visited Black Country Healthcare NHS Foundation Trust, they found areas where improvements were needed to ensure patients are cared for appropriately.
“Staff didn’t always support patients to understand and manage their treatment or condition. We found examples where patients had not had their rights under the Mental Health Act explained to them and instances where they had not been provided with copies of their care plans.
“Care plans were not always personalised or recovery-focused and were not updated when patient’s needs changed. Some risk assessments had been used from previous admissions meaning patients could be at risk as their plans did not represent their current status.
“We saw that staff were discreet, respectful, and responsive when dealing with people, but some patients raised concerns that night staff were not as caring and supportive as day staff. There should always be a continuation of care for patients regardless of the time of day.
“Inspectors did also see some areas of good practice. Patient safety incidents were well-managed, and staff knew how to report these appropriately. Managers also investigated incidents and shared lessons learned with the wider service to prevent reoccurrence.
“In addition, managers were supportive and provided supervision and opportunities for staff to develop their skills. Staff from different disciplines worked together as a team to benefit patients.
“The trust knows where we expect to see improvements. We will continue to monitor the service closely to ensure the necessary improvements are made.”
The introduction of an electronic recording system had been problematic, due to COVID-19 affecting face-to-face support and training. All permanent staff could access information easily, but bank and agency staff were unable to access it and had to rely on full-time staff to log their entries, which added to busy workloads.
The service had a high usage of bank and agency staff and was undergoing a recruitment programme at the time of inspection.
Following the inspection, the trust must ensure the following improvements are made:
- Any risks to the health and safety of patients must be assessed and plans to mitigate reoccurrences must be made
- The premises must be safe and free of any potential risks
- All staff involved in patient care and treatment must have access to the electronic patient record system
- Patient care plans must be personalised, holistic and recovery orientated
- Staff must explain to patients their rights under the Mental Health Act in a way that they can understand.
Full details of the inspection are given in the report published on our website.
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