Southend University Hospital NHS Foundation Trust failing some essential standards of care for people with mental health needs

17 January 2011

The Care Quality Commission (CQC) has found that Southend University Hospital NHS Foundation Trust is failing to meet essential standards of quality and safety in services it provides for people with mental health needs.

Shortcomings include unacceptable delays in carrying out psychiatric assessments of patients in the Accident and Emergency department and delays in moving people to more suitable services, often due to delay in receiving external specialist input.

The trust has invested in measures to reduce risk for people who may be at risk because of their mental health needs, with the establishment of ‘safe rooms’ and environmental improvements, but further improvements are needed.

Inspectors found that hospital staff do not receive enough training to give them the skills and knowledge to meet the requirements of people with mental health needs, which the trust has begun to address through the introduction of a safeguarding lead.

CQC inspectors visited the trust on October 12 in response to two serious incidents reported to CQC by the Trust that occurred earlier in the year. Inspectors looked at issues relating to the care and welfare of people who use services, the safety and suitability of premises and how well staff were supported.

Inspectors noted one moderate and four minor concerns with five essential standards and have given the trust 28 days to show how it will achieve compliance. By law, providers of care services have a legal responsibility to make sure they are meeting the essential standards of quality and safety.

Inspectors were particularly concerned about the potential risks to the health, safety and welfare of service users with mental health needs due to delays in assessment and accessing the right healthcare professionals for treatment. They found that support from specialist psychiatric nurses employed by the local mental health trust was only available between 2pm and 10pm. Staff spoke highly of the mental health nurses when they were available, the real issues being the limited hours they were available and the lack of a formal service agreement. Outside these times support was only available from inexperienced junior doctors who have to travel to the hospital.

The length of time it can take to arrange a transfer to a mental health unit is sometimes a problem. Inspectors were told that waiting times can be prolonged to the point that a patient walks out – especially at night when there is no transfer service until 7am.

Frances Carey, CQC Regional Director, said: "At the heart of our findings is the fact that the trust does not have a high level policy that covers all of its services to people with mental health needs.

"While we found some positive actions had been taken, such as providing ‘safe rooms’ for people who may be at risk because of their mental health needs and the appointment of a ‘safeguarding lead’, these had not always been carried through as well as they should have been.

"Although some progress has been made in liaising with the local mental health trusts; more needs to be done to formalise these arrangements to ensure more timely availability of specialist advice and care over the full day. In addition, we didn’t see evidence of formal liaison arrangements with other agencies such as the police, ambulance trust and local authority.

"The trust must now demonstrate that it has addressed the shortfalls identified during this inspection."

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For further information please contact Nicola Stewart on 0121 600 5344 or the CQC press office on 0207 448 9401 (07917 232 143 out of hours).

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