Chief Inspector of Hospitals publishes report on Cumbria Partnership NHS Foundation Trust

England's Chief Inspector of Hospitals has told Cumbria Partnership NHS Foundation Trust that it must make improvements following its first comprehensive inspection by the Care Quality Commission in November 2015.

Cumbria Partnership NHS Foundation Trust has been rated as Requires Improvement overall. The trust was rated as Good for providing services that were caring, and rated as Requires Improvement for providing safe, well-led, effective and responsive services.

Full reports including ratings for all core services are available at: www.cqc.org.uk/provider/RNN.

Cumbria Partnership NHS Foundation Trust provides mental health, learning disability and community physical health services across Cumbria to a population of approximately half a million people.

Inspectors found many areas of good practice but too many areas where improvement was required. Staff treated patients and their relatives with kindness, dignity, respect and compassion. Most patients shared positive experiences of care and treatment from the services they used. There was evidence of good communication between professionals involved in providing care and treatment.

Dr Paul Lelliott, the Deputy Chief Inspector of Hospitals (and CQC lead for mental health), said:

“We found that the quality of the services provided by Cumbria Partnership NHS Foundation Trust was variable.

“The trust must do more to enable its staff to acquire the skills needed to provide high quality patient care. They need a robust system to record staff training and appraisal and they must ensure that their staff knowledge required to follow national best practice and guidance. We also found that some multidisciplinary clinical teams had vacancies in key posts such as consultant psychiatry and occupational therapy.

“I compliment the trust on its innovative work in the areas of perinatal care and end of life care. It was also clear to our inspectors that some excellent practice was taking place with working age adults, older people and within community mental health.

“The trust must work to improve those services where we found problems and maintain its areas of undoubted good practice. Should they be able to do so, I am hopeful of being able to report improvement at the next inspection”

The inspection identified a number of areas where the trust must improve including:

• The trust must ensure that staff are trained and implementing the principles and requirement of the Mental Capacity Act (2005) including the Deprivation of Liberty Safeguards.

In community health services for adults:

• The trust must ensure that at all times there are sufficient numbers of suitably skilled, qualified and experienced staff in line with best practice and national guidance taking into account patients’ dependency levels.

Wards for people with learning disabilities or autism:

• The trust must ensure that care and treatment is planned and delivered in line with best practice guidance and that care plans are holistic, person-centred and treatment focused.

Specialist community mental health services for children and young people:

• The trust must ensure that risk assessments are completed fully and regularly reviewed and maintained for all people who use the service. This must include a system for monitoring risk for young people waiting for first treatment intervention

The inspection team found several areas of good practice, including:

• In the long stay and rehabilitation wards for working age adults - the ward was completely self-catering. All patients had a weekly budget for their food shopping and staff supported them to make a shopping list and go out to buy the ingredients. The patients maintained a vegetable and herb patch in the outside area and this was used in their cooking
• In community health services end of life care, patients and families told us that staff continuously assessed the level of pain and discomfort so that patients received appropriate and sufficient treatment to promote comfort. Treatment was not always medication as patients received alternative therapy such as massage to relieve anxiety and help with relaxing and easing pain
• The trust had identified nurse leads who had developed effective working relationships with the local maternity service to provide perinatal wellbeing groups. NICE guidelines were used to provide an in-reach service to support the development of pre and postnatal plans with pregnant women. Staff reported effective relationships with the local authority, and there was timely access to psychological therapies and a mother and baby unit if appropriate

The Care Quality Commission will present 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.

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