The Care Quality Commission (CQC) has welcomed improvements to a service provided by Sheffield Health and Social Care NHS Foundation Trust but calls for further progress, following an inspection in December.
CQC carried out an unannounced inspection of acute wards for adults of working age and psychiatric intensive care units (PICU), to follow up on concerns identified at the last inspection in May 2021, when they were rated as inadequate overall and issued with a warning notice.
Following this inspection, the service has improved from a rating of inadequate to requires improvement overall, as well as for being safe, responsive, and well-led. The ratings for effective and caring remain as requires improvement. Due to the improvements made, the trust showed that it has worked hard to meet the requirements of the warning notice.
Brian Cranna, CQC’s head of hospital inspection (mental health and community health services), said:
“During this latest inspection, we welcomed the improvements we saw at the trust. Staff worked well together as a team and most people were positive about their care and told us they felt safe, and thought staff were supportive and caring.
“Inspectors also found the trust has made improvements to the overall cleanliness of the wards, and one of the wards was closed for a full refurbishment. This work is ongoing and will ensure people receive care in an environment suitable for their needs.
“Although some improvements have been made, we still have concerns in some areas; including managers not ensuring that blanket restrictions on the wards were individually risk assessed, as well as concerns around the restrictive care provided to patients in the health-based place of safety suite. We also found staff did not always follow best practice when responding to challenging situations, although some staff were positive about the training they had received to help them deal with this.
“Inspectors saw that patient health checks were not always consistent, and there were some occasions when details of a patient’s whereabouts when they left the ward were not recorded, which could result in them coming to harm. In addition, although there had been a reduction in ligature risks, these were not always identified in all assessments on one of the wards which could put vulnerable patients at risk of harm.
“Leaders know where further improvements are needed, and we continue to monitor the trust to check they achieve the required progress.”
Inspectors found:
- Staff did not always assess and manage risks to patients’ physical health
- Ligature points must be detailed on relevant risk assessments to mitigate risk
- Managers did not ensure that all staff received training
- Managers did not ensure that blanket restrictions on the wards were individually risk assessed and proportionate
- Staff did not always inform and involve families and carers appropriately.
However, there had been some areas of improvement:
- Mandatory training levels in the management of aggression and violence had improved
- The ward teams included or had access to the full range of specialist staff
- Staff followed good practice with respect to safeguarding, treated patients with compassion and kindness.
Full details of the inspection are given in the report published on our website.
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