Wards for older people at a north London mental health trust have been rated Good overall by the Care Quality Commission.
Wards for older people with mental health problems at North East London NHS Foundation Trust were rated Good for being safe, effective, caring, responsive and well-led following the inspection in August 2017.
At a previous inspection of these wards in 2016 CQC found the trust was in breach of regulations relating to safety, dignity and respect and staffing. However, at this most recent inspection, inspectors found that the trust had taken appropriate action to improve the service.
There was a robust system in place to reduce the risk of falls. Patients were now able to access their bedrooms at any time as they wished. The trust had improved ward premises. The wards had been redecorated, there was new furniture and the risk to patients from potential ligature points had been reduced. Patients on all wards now had easily accessible call bells to alert staff if they needed support.
Staff thoroughly assessed patients in relation to their physical and mental health when they were admitted to the ward. Staff screened patients for risks in relation to falls, skin care, continence and nutrition.
Staff checked the physical health of patients each day and took action to address any deterioration in the patient’s health. Patients were encouraged to be as independent as possible. There was a range of activities available.
Staff were seen to be kind and caring. They were able to communicate well with older frail people. Staff welcomed carers onto the wards and gave carers appropriate support and advice.
However, patients on some wards were accommodated in shared bedroom areas which compromised their privacy and dignity.
CQC also inspected the trust’s specialist community mental health services for children and young people during August 2017. This service was not rated. The current CQC rating for this service is Good based on the 2016 inspection.
At a previous inspection in April 2016, CQC found that systems to monitor changes in risk for children and young people waiting for assessment and treatment were not robust and not all patients had a care plan. At this most recent inspection, CQC found there had been improvements in this area. Patients who had been assessed or had commenced treatment had risk assessment and management plans in place. All patients had a care plan. However, further improvement was needed as half of the care plans examined did not include goals for recovery.
The trust was maintaining safe staffing levels and recruiting to vacant posts. They employed agency staff to cover the majority of unfilled posts.
Staff were compassionate, demonstrated an in depth knowledge of the young person’s circumstances and were respectful towards them. Young people felt listened to and said that their views were valued.
Team managers were experienced and led staff teams effectively. Service wide changes were being made as a result of learning from a recent cluster of serious incidents.
There were still some areas that the trust needs to improve:
- The trust was not meeting its target times for referral to assessment of 12 weeks.
- Alarm systems to ensure the safety of staff and patients were not in use.
- At some sites children and young people’s privacy and dignity were compromised as height and weight measurements were taken in a corridor.
Paul Lelliott, Deputy Chief Inspector (lead for mental health), said:
“The trust is to be commended for taking action to improve the quality if its wards for older people with mental health problems. We have now rated them as Good for each of the five key questions that we assess."
“Staff were kind and caring. They were able to communicate well with older frail people. They welcomed carers onto the wards and gave them appropriate support and advice."
“The trust has also made a number of improvements to the specialist community mental health services for children and young people. There are, however, further improvements that need to be made. Management and staff are aware of what needs to be done to achieve this.”
You can read the two reports in full on our website.
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