The Care Quality Commission (CQC) has found some improvements following an inspection of specialist community mental health services for children and young people at Birmingham Women's and Children’s NHS Foundation Trust, in August. The rating for the service has changed from inadequate to requires improvement.
The inspection was carried out to check if improvements had been made since the previous inspection when the service was rated inadequate overall. Inspectors visited the specialist community mental health services for children and young people.
Birmingham Women's and Children's NHS Foundation Trust is responsible for managing Forward-Thinking Birmingham. Forward Thinking Birmingham is one of the largest child and adolescent mental health services in England. It has a dedicated inpatient eating disorder and acute assessment unit for regional referrals of children and young people with the most serious mental health concerns and provides community mental health services for 0–25-year-olds.
Following the inspection, as well as the overall rating for community mental health services for children and young people, the ratings for safe, responsive and well-led have also moved up from inadequate to requires improvement. How effective and caring were rated requires improvement again.
The overall rating for the trust remains as requires improvement.
Amanda Lyndon, CQC deputy director of operations in the midlands, said:
“When we inspected this service, whilst there are still areas where improvements need to be made, it was positive to see some areas of improvement, and leaders must now ensure further changes are made and the ones already made are sustained.
“Not enough action had been taken since our previous inspection to ensure the premises were fit for purpose for children and young people. Staff had raised concerns about disabled access sites, children and adults sharing facilities, a lack of clinical space, and important equipment being unusable.
“It was also concerning that teams didn’t have access to the full range of specialists required to meet the needs of children and young people. There were nursing, multidisciplinary team and consultant vacancies which impacted waiting lists.
“However, it was positive that improvements had been made to how staff managed risk and learned from incidents. We saw some good examples of staff working well with services outside the trust, especially regarding safeguarding. The trust had specialist safeguarding nurses who offered support across the service.
“We observed kind, respectful, and compassionate staff who worked hard and actively involved parents and carers in any decisions being made.
“We will continue to monitor the trust, including through future inspections, to ensure further improvements are made so people can receive safe and appropriate care.”
Inspectors found the following during this inspection:
- The trust used systems to help them monitor waiting lists and staff assessed and treated people who required urgent care promptly
- Staff provided a range of treatments that were informed by best-practice guidance for children and young people
- Managers monitored caseloads and had improved processes to ensure people were not lost to follow up and that staff contacted children and young people who did not attend appointments
- Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers.
However:
- Not all interview rooms in the service had sound proofing to protect privacy and confidentiality
- The teams did not include or have access to the full range of specialists required to meet the needs of people
- The service had not acted on feedback from children and young people about the environment at the East Hub including the waiting area, hallways, entrance, and therapy rooms.