England’s Chief Inspector of Hospitals has rated the services provided by Leeds and York Partnership NHS Foundation Trust as Requires Improvement following inspections by the Care Quality Commission. This overall rating for the trust is unchanged since our last full inspection of the trust in July 2016.
A team of inspectors visited acute wards for adults of working age and psychiatric intensive care units, forensic inpatient/secure wards, child and adolescent mental health wards, wards for people with learning disability or autism, mental health crisis services and health-based places of safety, the specialist service, the National Inpatient Centre for Psychological Medicine, and supported living services at St Mary's Hospital in January 2018. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
Inspectors rated the trust as Requires Improvement overall. It was rated Good for being caring, responsive and well-led and Requires Improvement for being safe and effective.
At the previous full inspection of the trust in July 2016, CQC issued four requirement notices. The National Inpatient Centre for Psychological Medicine did not meet the requirements of guidance issued by the Department of Health on same sex accommodation. Emergency equipment and medication checks were not sufficiently robust on some wards and there was no physical health monitoring of antipsychotic medication. Incidents were not always reported or in a timely way.
Although, at this inspection of the trust in January 2018, inspectors found that most of those issues had been addressed by the trust, there was still not enough supervision of clinical staff in some departments and patient records in some areas were not always being maintained in a consistent manner.
The trust was now rated Good for well led, with commitment from experienced leaders to improving services by learning from areas of strength and areas of development. The leadership team ensured they visited all parts of the trust and fed back to the board to discuss challenges staff and the services faced. There was also a newly developed strategy was directly linked to the vision and values of the trust. The trust involved stakeholders in the development of this strategy.
The rating for acute mental health wards for adults of working age and psychiatric intensive care units has changed from Good to Requires Improvement following this most recent inspection. While patients were positive about their care, inspectors found in some cases staff did not monitor patients physical health needs following use of rapid tranquilisation in accordance with national guidance and trust policy.
The National Inpatient Centre for Psychological Medicine remained rated as Good, with effective and caring rated Outstanding. However the ward did not have enough space and facilities to support occupational therapy, physiotherapy, and recreational activities. Staff and patients used communal areas and rooms for multiple purposes which impacted on places for visitors and quiet areas, and access to outside space. Patients’ bedrooms did not contain anywhere to keep their belongings secure. While managers recognised the limitations, the difficulties to secure a long-term resolution remained and the trust still had no timescale or confirmed plans for the proposed new location for the service.
Mental health crisis services and health-based places of safety had improved; and the rating has changed from Requires Improvement to Good. People who were referred to the crisis assessment service had mental health assessments carried out. Physical health checks were also offered to patients who were admitted to the crisis assessment unit. Staff had regular supervision and appraisals.
The trust’s supported living service at St Mary’s Hospital for people with a learning disability had also improved from Requires improvement to Good overall and was rated Outstanding for being caring.
Dr Paul Lelliott, CQC Deputy Chief Inspector of Hospitals (and lead for mental health), said:
“During this inspection we found a number of improvements had taken place, with good and outstanding practice in many areas. Staff cared for patients with compassion and treated them with dignity and respect.
“However, we have once again rated the trust as requires improvement overall; which indicates that the leadership team still have more work to do. Although we found that practice relating to the administration and storage of medication, and the monitoring of the physical health of patients had improved, there is still room for more to be done in these areas. Our inspectors will return at a later date to check on what progress has been made.”
Full details of the ratings, including a ratings grid, are available on our website.
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