The Care Quality Commission (CQC) has published a report on a service run by Hertfordshire Partnership University NHS Foundation Trust, following an inspection in November.
CQC inspected the trust’s wards for older people with mental health problems at Victoria Court, Stevenage, to assess whether the trust has acted on information of concern which, if unaddressed, could have undermined the quality and safety of care people using the service received.
This included issues with people of opposite genders mixing in bedrooms, access to communal areas, observations and the administering of medicines by agency nurses.
The inspection found the trust had addressed these concerns and that people were generally receiving good standards of care.
No ratings were issued following this inspection as it was focused on specific concerns.
Ratings for the trust and service are unchanged following this inspection. The trust remains outstanding overall and its wards for older people with mental health problems remains good.
Craig Howarth, CQC head of inspection for mental health and community health services, said:
“The older people using Victoria Court were generally receiving good standards of care and treatment that ensured their safety and supported their recovery.
“Wards were clean, well-maintained and appropriately furnished, and patients received timely care because there were enough staff to meet their needs. Supporting this was a good culture, where staff felt valued, empowered and confident to provide good care.
“However, there were a few areas the trust should address – including ensuing people could be observed in all areas, and that records were completed appropriately to support this.
“We’ve reported our findings to the trust to support it to build on where it’s providing good care to people, and to help it address areas where improvements can be made.”
The inspection found:
- Wards were clean, well maintained, well-furnished and fit for purpose. New furniture, which was appropriate for people using the service, had been bought, and cleaning records were up to date
- There were enough nursing and medical staff. They knew the people using the service, and they received training to keep them safe from avoidable harm
- Staffing levels were adjusted to meet demand, and there were low vacancy rates
- Capacity and best interest meetings had taken place when considering the use of bed rails and covert administration of medicines. Outcomes were recorded in people’s records and reviewed on a regular basis
- Staff said they were proud to work at Victoria Court, having received positive comments from other staff, visiting colleagues and student nurses. This helped build a positive culture and, in turn, supported good patient care.
However:
- Staff could not observe patients in all areas. Some mirrors were in place, but there were multiple blind spots and no clear lines of sight in some areas. Patients at high risk of falls, violence or aggression received enhanced observations to mitigate these risks
- Managers did not ensure all observation records were validated at the end of each shift
- Inspectors saw two staff feeding a seated patient from a standing position, which could be considered overbearing.