CQC inspectors rate services provided by Cornwall Partnership NHS Foundation Trust as Good

England's Chief Inspector of Hospitals has found the quality of services provided by Cornwall Partnership NHS Foundation Trust to be Good following an inspection by the Care Quality Commission.

Overall the trust has been rated Good for providing services that are safe, effective, caring, responsive and well led. Cornwall's Long stay and rehabilitation mental health wards for adults of working age were rated Outstanding.

A team of CQC inspectors and specialist advisors spent three days inspecting the core services provided by Cornwall Partnership during April this year. Full reports of the inspection including ratings for all core services are available at www.cqc.org.uk/provider/RJ8.

Cornwall Partnership NHS Foundation Trust provides mental health services and learning disability services to people of all ages in Cornwall and the Isles of Scilly, as well as community health services to children and young people.

The inspectors found that patients were protected from abuse and avoidable harm. There were systems in place to report when things go wrong with lessons learned and improvements made.

Most patients said they received good care. Inspectors found staff providing skilled interventions in a caring and respectful way across all the core services, whether in hospitals or in the community. In the rehabilitation and long stay service at Bodmin Hospital and in community learning disability services, care was outstanding.

Some services were short of staff. The trust was working to recruit more staff and tried to fill vacancies by using locum, bank and agency staffing. However, staffing problems at the child and adolescent mental health service, coupled with the high number of referrals, meant that some young people waited a long time to be seen unless they were in a crisis. One family told inspectors that their daughter had to wait for a year to receive care because she had been assessed as being at low risk.

CQC rated the long stay service at Fettle House, Bodmin Hospital as Outstanding. All new admissions were assessed with staff involving them and their carers in their care plans. Patients were actively encouraged to develop their independence, and when the time came for discharge they were assisted to plan their accommodation needs. A team of social inclusion workers helped patients bridge the gap between hospital and community by using a wide range of local services and facilities.

However, there was often a shortage of beds for acute admissions in the trust, which meant that patients sometimes had to be admitted to wards outside of Cornwall.

There had been an increase in staffing, with improved working arrangements with social services and the police to meet the needs of people in times of crisis. The numbers of people being brought into the place of safety rather than into a police station has gone up. However the inspectors found that people with learning disabilities, children and young people, and older people who experience a mental health crisis had limited access to crisis care from staff with specialist expertise outside of office hours.

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

"Overall we have found that the services provided by Cornwall Partnership are Good, and in some places Outstanding. Most people we met, either as patients or carers, spoke highly of the care and that is reflected in these ratings.

"Generally we found that services are organised so that people’s needs are met. However, the geography of Cornwall means that staff working in the community often have to travel long distances and this can affect their ability to provide prompt care to all in need.

"We have found some areas for improvement, particularly in child and adolescent mental health services. Some young people are waiting too long for appointments. Also, too often there is a shortage of beds available for people who need urgent admission to hospital. We were also concerned about the cleanliness and maintenance of the mental health facilities at Bodmin Hospital. The trust has assured us that it has already taken action to address this.

"The trust is well led. We have seen there are systems in place which ensure that the senior management is aware of the strengths and weaknesses of their services. We are confident that they will address the issues we have identified in this report. We will return in due course to check on their progress."

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

• The trust provides training and support to health and social care providers to ensure that people with learning disabilities get support when they need it.
• In the rehabilitation and long stay ward, patients are supported to look after and administer their own medicines, with support given after they have left the hospital.
• The community forensic team provided support for patients making the transition from inpatient care to the community, contributing to a 33 per cent reduction in the time police had to spend with individuals.
• At the Trelil Court day resource centre at Bodmin the trust had just introduced a scheme to provide IT training which was aimed at helping patients return either to work or further study.
• Among specific projects aimed at improving community services for adults was the development of a new approach to dealing with psychosis called open dialogue. A team from Finland who had developed this approach provided training to staff.

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

• The trust must ensure that all staff and team managers in learning disability services have access to effective support and supervision. 
• All staff working in the acute wards and psychiatric intensive care unit must understand the steps they need to take to reduce the risks of ligature points to patients.
• The trust must take action to reduce the blind spots in the seclusion rooms in Harvest ward so that staff can observe patients at all times.
• The cleaning and maintenance of the wards at Bodmin hospital must be improved.
• There must be enough competent staff in child and adolescent mental health services to meet the needs of the population safely, particularly out of hours.

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.

Ends

For further information, please contact John Scott, Regional Engagement Manager on 07789 875809. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. (Please note: the press office is unable to advise members of the public on health or social care matters.)

For general enquiries, please call 03000 61 61 61.