A combined trust providing community and mental health services delivering care across north-west London, Milton Keynes and other parts of the south-east has made significant improvements since its last inspection and has been rated Good overall by the Care Quality Commission.
Central and North West London NHS Foundation Trust (CNWL) has been rated Outstanding for being caring, Good for being effective, responsive and well-led and Requires Improvement for being safe.
CQC undertook this inspection to find out whether CNWL had made improvements since February 2015, when it rated the trust as Requires Improvement overall.
Since the last inspection the trust has made considerable improvements especially in their inpatient mental health services. Whilst there are still significant pressures for adults needing to access an inpatient bed for an acute mental illness the trust has improved how it is managing beds across the trust. Steps have been taken to make ward environments safer and to ensure there are sufficient staff to meet the needs of the patients. On wards for older people with mental health problems, patients of different genders are appropriately separated to promote their dignity and emergency resuscitation equipment is accessible. In addition patients with mental health needs are receiving improved support with their physical health.
There are however areas where the trust still needs to improve. Further work is needed to reduce the number of incidents of restraint including prone restraint. Records of restraint need to be completed correctly so this can be monitored. Where rapid tranquilisation is used, the appropriate checks must be carried out afterwards to ensure patient safety. We also found some challenges in the community based mental health services for adults of working age. Staff turnover is very high and patients are not always receiving consistent care. In addition many patients are not receiving timely access to psychological therapies.
Paul Lelliot, Deputy Chief Inspector (Mental Health), Hospitals, said:
“I am very pleased at the improvements that have been made at Central and North West London NHS Foundation Trust. The trust has a skilled and experienced leadership team who are committed to providing high quality services. Its Good overall rating is a testament to the staff at the trust and the successful implementation of the trust’s comprehensive improvement plan.”
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