The Care Quality Commission (CQC) has welcomed improvements in two services run by Norfolk and Suffolk NHS Foundation Trust, following inspections it undertook in November 2020 – but the trust must make more progress to ensure patient safety.
CQC inspected the trust’s acute wards for working-aged adults, which provide psychiatric intensive care. It also inspected the trust’s mental health crisis service, where people who have been sectioned under the Mental Health Act receive initial assessment.
These services are provided from several of the trust’s locations including Hellesdon Hospital in Norwich, Northgate Hospital in Great Yarmouth and the Woodlands unit at Ipswich Hospital.
The inspections were undertaken in response to potential risks to patient safety, and to review progress with improvements that CQC had said were needed following its previous inspection of these services, which took place in October 2019.
The latest inspections found that the trust had made significant improvements in several areas, but further work was still needed to improve patient safety in these services.
Following the inspections, both services were rated Requires Improvement. They were also rated Requires Improvement after CQC’s previous inspection.
The inspections were not wide-ranging enough to update the trust’s overall rating. It remains Requires Improvement overall.
Stuart Dunn, CQC head of hospital inspection for mental and community health services, said:
“I welcome the improvements that have been made in the services that we assessed, but the trust has further work to do to ensure that these services meet standards that people should be able to expect.
“The services did not always manage risks well. This had led to patients self-harming on the trust’s acute wards for working-aged adults.
“Patients waited too long for assessment in its mental health crisis service, and staff in this service did not always maintain comprehensive records about people’s medication. This service’s care was impaired by a high number of vacancies.
“Both services should make better use of debriefings following incidents, such as when staff had restrained patients to prevent them from harming themselves and others. Learnings, identified through debriefings, should be shared across the organisation to help it improve.
“However, we saw a number of areas of improvement and new good practice – and it is clear the trust and members of its staff are working hard to maintain progress.
“Staff told us that they felt more listened to by the trust, and we saw evidence of an improving culture.
“Patient areas were clean and well equipped, and measures had been implemented to protect people from COVID-19.
“Staff knew how to protect people from abuse, and they told us that they felt empowered to speak up when they had concerns about issues that could affect people’s care and wellbeing.
“Following the inspection, we reported our findings to the trust. We continue to monitor it closely to ensure that patients receive safe and effective care and treatment.”
CQC has told the trust that it must make several improvements to meet its legal obligations in its crisis service, including:
- Following systems and processes to safely prescribe, administer, record and store medicines
- Holding debriefings following incidents, and sharing outcomes and lessons learned with all staff
- Meeting referral-to-assessment targets
- Staffing the service adequately.
CQC has told the trust that it must make several improvements to meet its legal obligations in its acute wards for working-aged adults, including:
- Managing patient safety effectively
- Addressing patients’ physical healthcare needs, and ensuring staff complete relevant training to support this
- Applying governance processes consistently across all wards.
The inspection reports are available on the CQC website:
Mental health crisis services and health-based places of safety
Acute wards for adults of working age and psychiatric intensive care units
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