Chief Inspector of Hospitals publishes his findings on Devon Partnership NHS Trust

17 April 2014

England's Chief Inspector of Hospitals has published his first report on the quality of care provided by Devon Partnership NHS Trust.

Devon Partnership NHS Trust was one of the first mental health trusts to be inspected using a radical new approach to inspections which has been introduced by CQC to provide a more detailed picture of healthcare than ever before.

Overall the report concludes that the trust provides some good and excellent mental health services. But the trust had a number of challenges, especially in its services for adults of working age who need urgent mental health care.

An inspection team of 37 people, which included CQC inspectors and analysts, doctors, nurses, social workers, Mental Health Act commissioners, psychologists, patient experts by experience and senior managers, spent four days visiting the trust’s hospitals and community services across Devon during February.

They examined the care provided on acute admission wards and health-based places of safety, long stay forensic secure services, services for older people, services for people with learning disabilities or autism, adult community-based services including crisis services, and specialist eating disorder services.

The inspection team found areas of good practice which included:

• Staff supporting patients with care and compassion and a high level of commitment to providing a good quality service.
• The trust was an open, honest organisation with a strong commitment to improving practice through learning from incidents.
• Good collaboration with other organisations to meet the needs of people with mental health problems in Devon. This has resulted in some new initiatives, such as a crisis house in Torbay and some high-quality work around safeguarding and the Mental Capacity Act.
• Good and excellent services included the specialist inpatient eating disorder service and some inpatient and community services for older people and for people with learning disabilities.
• Medication management across the trust was of a high standard.

Inspectors said that the trust must improve in a number of areas:

• Many adults of working age who needed acute inpatient care were being admitted to services long distances from their homes because a bed was not available locally.
• Too many patients in crisis were being taken to police stations or to the local hospital emergency department rather than to the trust’s own designated places of safety.
• People, mainly in the Exeter area, who may need to be detained under the Mental Health Act were often having to wait a long time to be assessed by an approved doctor. People being supported by the crisis teams were sometimes not able to reach a care professional out of hours.
• Many people did not have access to the specialist psychological therapies they need to help them to recover.
• Seclusion was being used without suitable arrangements in place to ensure that it was properly recognised, recorded and monitored to ensure physical interventions were used appropriately.

Following this inspection, the Care Quality Commission has issued a warning notice to the trust because it had failed to complete improvements which were identified by a previous inspection at Coombehaven ward at Wonford House Hospital. Inspectors found that patients on this admission ward for adults of working age were still not consistently involved in the preparation of their care plans or had regular access to their named nurses.

Dr Paul Lelliott, CQC’s Deputy Chief Inspector of Hospitals, said: “Generally, we have found services at Devon Partnership Trust to be safe, with a strong culture of learning from incidents at individual sites and across the trust. However, staff providing cover out of hours are not always able to respond effectively to mental health crises affecting people living in the community.

“Most of the patients and carers we met described staff as caring and compassionate. But while Devon Partnership NHS Trust provided effective services in many areas, the availability of the service can all depend on where you live, especially if you need input from a recovery care co-ordinator, timely access to a Section 12 approved doctor or specialist psychological therapies.

“The trust is aware of these shortcomings and is in discussion with those who commission its services and I hope that together they soon develop a clear plan to address these issues. The task of improving the services so that they reach all the people who need them, especially adults who need access to acute services, poses a significant challenge.”

Ends

For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07917 232 143.

For general enquiries, call 03000 61 61 61.

Notes to editors

Devon Partnership NHS Trust is the main provider of mental health services in Devon covering a combined population of 890,000 people.

CQC has published reports on services provided at Wonford House Hospital in Exeter, North Devon Hospital, Barnstaple, Torbay Hospital, Whipton Hospital, Franklyn Hospital, Langdon Hospital and by community mental health services situated throughout Devon, Plymouth and Torbay.

Read the full reports on our page for Devon Partnership NHS Trust.

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.