The Care Quality Commission (CQC) has found significant improvements at Langley Green Hospital, after Sussex Partnership NHS Foundation Trust was issued with a warning notice following an inspection in February.
At an unannounced focused inspection in February, CQC found that the physical healthcare needs of people at Langley Green Hospital weren’t always being met, putting patients at risk of harm. The warning notice required the trust to make immediate improvements.
Following this inspection in February, and due to the significance of CQC’s findings, the overall rating for the acute mental health wards and psychiatric intensive care units at the trust moved from good to requires improvement. The individual ratings for whether the service was safe, effective and well-led moved from good to requires improvement. However, the outstanding rating for caring and the good rating for responsiveness remains the same.
The warning notice that CQC served required the trust to take urgent action to review the risk assessments and care plans for all patients with physical healthcare needs, to ensure patients get the care they needed, when they needed it.
CQC undertook a second focused inspection in March to check whether the trust had met the requirements of the warning notice and found significant improvements had been made, so the warning notice was lifted.
As this second inspection was only to check on the progress of the warning notice, the ratings from the inspection in February remain.
Karen Bennett-Wilson, CQC’s head of hospital inspection for mental health, said:
“We inspected Langley Green Hospital in February because we had concerns about how well staff were monitoring and taking care of the physical health needs of patients, alongside their mental health needs.
“Following this inspection, we issued a warning notice to the trust and told them that they had to make immediate improvements to ensure patients were kept safe and had their physical healthcare needs met.
“I am pleased to report that inspectors found significant improvements when they returned to the trust in March and found the conditions of the warning notice had been met.
“We found that processes had been put in place to ensure the physical health care needs of people were assessed on admission alongside their mental health needs. People with physical healthcare needs were now having these met and were also being monitored consistently, throughout their stay in hospital.
“The trust had also addressed its staffing issues and now had enough staff, with the right skills and experience on wards, to meet people’s needs.
“All the staff we spoke with were passionate about working at the hospital and we saw they were kind and caring to patients.
“We will return to Langley Green Hospital to ensure these improvements are embedded.”
Inspectors found:
- The service now had enough nursing and support staff to keep people safe and had addressed staffing concerns from the February inspection by employing agency nurses on a longer-term basis and changing the working hours of senior staff to cover the service 24 hours a day
- Staff had received training in how to meet people’s physical health needs, and now reviewed them at every handover and at the daily safety huddle. There is also a physical health team that visits the hospital twice a week, and each ward now has two physical health champions
- Staff knew how to escalate concerns about physical health, and documentation was thorough, enabling them to do so, as well as helping them to facilitate regular monitoring
- There was now enough staff to manage individual wards, but staff told inspectors they felt there wasn’t always enough if they had to support incidents on other wards, as it would leave their own ward understaffed
- Doctors had not reviewed do not attempt cardiopulmonary resuscitation decisions on arrival and staff did not always discuss these decisions with patients, however the trust took immediate action to address this
- The physical health audit that managers had introduced didn’t identify that staff weren’t routinely assessing patients’ risk of blood clots on admission in line with the National Institute for Health and Care Excellence (NICE) guidelines. However, the provider has now updated the audit to include this.