The Care Quality Commission (CQC) has published a report following an inspection of the child and adolescent mental health services’ (CAMHS) psychiatric intensive care unit (PICU) at Bethlem Royal Hospital, run by South London and Maudsley NHS Foundation Trust in September.
The CAMHS PICU inpatient service treats children and young people from age 12 to 18 years old. The ward can accommodate up to seven people but was only admitting up to three young people at the time of inspection.
This inspection was carried out to see if improvements had been made following a serious incident which occurred on the ward in June this year.
Inspectors did not re-rate the service following this latest inspection. Therefore, the ratings from the previous inspection remain in place. The overall rating for the CAMHS PICU unit remains rated as good.
The overall rating for the South London and Maudsley NHS Foundation Trust remains as good.
Jane Ray, CQC deputy director of operations in London, said:
“When we inspected the child and adolescent mental health services’ psychiatric intensive care unit at Bethlem Royal Hospital, we found that there had been a number of improvements but there was more to do.
“The trust were working hard to recruit enough qualified nursing staff and ensure they had the training needed to meet the needs of the young people using the service. While this was taking place they were keeping young people safe by restricting admissions to the ward.
We received positive feedback from young people and their families about the quality of care they received. Young people said staff treated them well and behaved kindly. We saw that staff spoke compassionately about young people and their loved ones.
“We also found that staff morale had improved and staff felt able to raise concerns with senior leaders when needed.
“However, we identified the need for further assurance that staff would be confident to respond appropriately to a medical emergency on the ward.
“We will continue to monitor the service closely through future inspections, to ensure people are receiving safe care.”
Inspectors also found:
- There were certain aspects of the ward's environment that required improvement. For example, an up-to-date risk assessment for ligature was not readily available for all staff members and the ward didn’t have a specific lounge area for females, to adhere to guidelines for mixed-sex accommodation
- Some improvements were also needed in medicine management and the organisation of the clinic room
- When things went wrong, this wasn’t always discussed at team meetings to protect people in future.
However:
- Staff worked to reduce the levels of restrictive interventions used on young people. The ward had a lead and a senior manager that focused on reducing restrictive interventions. Ward staff also attended monthly meetings regarding this
- Staff understood the individual needs of young people and supported them to understand and manage their care and treatment.