The Care Quality Commission (CQC) has published a report following a focused inspection of the acute wards for adults of working age, and psychiatric intensive care units at Elmleigh hospital in Havant, one of the acute mental health hospitals run by Southern Health NHS Foundation Trust.
The inspection took place in August, to see if the hospital had made the required improvements identified at a previous inspection in April. Following the April inspection, CQC set out the serious concerns it had about the safety and effectiveness of treatments being given to patients on the Blue and Red bay wards. The trust responded with a detailed action plan which provided assurance on what had been done immediately to improve care and treatment on the wards and also voluntarily capped admissions by reducing bed numbers on each ward by three. CQC were assured by this plan so no further action was taken.
As this was a focused inspection, the ratings for the service do not change and the rating for the service remains good overall.
Karen Bennett-Wilson, CQC’s head of hospital inspection and lead for mental health, said:
“When we inspected Elmleigh hospital, we found that a number of our previous concerns have now been addressed by Southern Health NHS Foundation Trust. “There have been big improvements in the psychological and therapeutic interventions being given to people, which are now in line with best practice, making their care much more effective.
“New staff are now receiving comprehensive inductions whilst working in Elmleigh, as well as regular supervision and training which has a direct positive impact on people’s care.
“Although staff now felt supported and more confident about raising concerns, they weren’t always reporting all incidents, especially if they deemed them to be low risk or was something that was a regular occurrence. This could put people at risk of harm.
“Staff also need to ensure that they are increasing observations for deteriorating patients to ensure they kept safe.
“The trust still needs to make a number of additional improvements, but the leadership team knows what it must do, and has already taken steps to ensure continuous, embedded improvements to ensure safe, effective care for all patients.
“We will continue to monitor the hospital to ensure the required improvements are made and will return to inspect and report on developments."
Inspectors found:
- Inspectors had previously identified a need for the hospital to provide a range of care and treatment interventions suitable for patients that are in line with best practice. Inspectors saw that patients now have access to meaningful activities and a range of psychological and therapeutic interventions
- CQC also pointed out that new staff needed a comprehensive induction and regular supervision. This has now been actioned so that staff receive a tailored and structured induction to the wards, with the opportunity to shadow shifts, as well as additional training. They also receive regular supervision, including reflective practice sessions and group sessions
- Staff felt supported and were more confident about raising concerns. Since the last inspection, a human resources advisor had based themselves on the wards so staff could approach them directly to discuss any concerns. The trust had also arranged ‘listening ear’ sessions, where staff external to the ward came in and held open door, drop-in sessions with staff
- The day-to-day running of the service had improved, and ward managers had put in place additional checks and audits to identify where improvements were still needed and prompt action could be taken
- Staff ensured that patients’ physical health needs were identified and assessed. Patients had the right physical health care plans in place which were reviewed regularly
- Improvements had been made with regards to patients’ mental state being assessed prior to taking leave from the hospital, although some patients said that this didn’t always happen.
However:
- Staff were not increasing physical health observations in line with the National Early Warning Score (NEWS2) protocol when patients’ health deteriorated. For example, if a score increased from two to three, patients were not having their observation checks increased from every 12 hours to every six hours. Patients’ baseline scores were missing and there was no rationale recorded for why these increased observations did not take place
- Staff were still not always reporting all incidents. For example, if an incident was a regular occurrence or was low risk of harm
- Although improvements had been made to the management of medicines, there were still gaps in recording on medications charts.
Full details of the inspection are given in the report published on our website.
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