CQC Chief Inspector of Hospitals finds that Pennine Care NHS Foundation Trust requires improvement

The Chief Inspector of Hospitals has rated the services provided by Pennine Care NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission.

CQC has rated trust services as requires improvement for being safe, effective and well led and as good for being caring and responsive. The trust’s child and adolescent mental health wards have been rated Outstanding.

Pennine Care NHS Foundation Trust provides mental health, community and specialist services to people living in Bury, Heywood, Middleton, Rochdale, Oldham, Tameside, Stockport, Glossop and Trafford in Greater Manchester.

The Deputy Chief Inspector of Hospitals, Mental Health, Dr Paul Lelliot said:

“Pennine Care NHS Foundation Trust provides a range of community and inpatient services that serves 1.3 million people across the Greater Manchester. People we met spoke positively about the care they received.

“Overall we have rated six out of 16 services as Requires Improvement. We were concerned that guidance on same sex accommodation was breached in a number of wards. We found concerns with the levels of training. Staff were not following the trust’s own policies to manage medicines in a number of services and we also found restrictions on patients’ liberty which had not been properly addressed.

“I note that across the trust bed occupancy has been very high and this has meant a number of patients having to be admitted to units out of the area.

“On the whole we found staff who were respectful, caring and had a professional attitude towards their patients. We also found multi-disciplinary staff teams that worked well across the trust both internally and with external agencies.

“Following this inspection, the trust has told us it is taking action to improve its services, and our inspectors will return in due course to check that the improvements we require have been made.”

The inspection has identified a number of areas for improvement including:

• The trust must ensure that patient areas are clean and in good decorative order and that, effective monitoring systems are in place to evidence this.
• The trust must ensure that patients are cared for in single sex accommodation in line with guidance to ensure safety, privacy and dignity of patients. The bathrooms should be available without members of each sex having to pass areas occupied by the opposite sex.
• The Trust must ensure that when patients who lack capacity are subject to restrictions, which may amount to a deprivation of liberty, staff consider the appropriate framework for providing care and treatment.
• The trust must ensure that each patient has a comprehensive assessment of his or her needs, an up to date risk assessment and care plan in place.
• The service must provide sufficient specialist palliative care staff to ensure that specialist advice and treatment can be provided in a timely manner.

The report also identifies a number of areas of good practice including:

• In the older people’s service, there was an innovative partnership with the local acute NHS trust, a local GP practice and the mental health trust to ensure that patients with delirium were not inappropriately placed on an acute medical ward.
• In the child and adolescent mental health inpatients service, staff had secured funding to train an expert parent who would provide support for others.
• In the end of life care service, the Oldham specialist palliative care team had undertaken a project to seek the views of the Bangladeshi and Pakistani community for end of life care, helping the service reshape the way it delivers care to these communities.

The reports which CQC publishes today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

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