The Care Quality Commission (CQC) has published reports on two services run by Barnet, Enfield and Haringey Mental Health NHS Trust following inspections in May.
Inspectors assessed the trust’s wards for older people with mental health problems, as well as the trust’s mental health crisis services and health-based places of safety.
Following these inspections, the rating for the trust’s wards for older people with mental health problems has dropped from good to requires improvement overall. This service also dropped from good to requires improvement for how well-led it is and was re-rated requires improvement for how safe it is. It was re-rated good for how effective, caring and responsive it is.
The trust’s mental health crisis services and health-based places of safety have been re-rated requires improvement overall. They’ve also been re-rated requires improvement for how safe and responsive they are. They’ve been re-rated good for how effective, caring and well-led they are.
Barnet, Enfield and Haringey Mental Health NHS Trust remains rated good overall.
Jane Ray, CQC deputy director of operations in London, said:
“When we inspected these services, we found leaders needed to make further improvements to people’s safety in some areas of known risk. However, most people received care from kind, skilled staff who knew how to meet their needs.
“For example, the trust had previously identified Silver Birches, one of the wards for older people, as a concern due to a high number of incidents around people’s physical health and risk of falls. In response, the trust introduced additional support from senior leaders.
“However, we found leaders didn’t always follow up on the progress of improvements they’d agreed to make, and staff weren’t always aware of the original concerns or the action being taken. This meant staff didn’t have the tools to improve people’s safety in future.
“Despite improvements in staffing, we also found the trust’s mental health crisis home treatment services in Enfield still had too many cases compared to their resources, meaning staff didn’t always have enough time to meet people’s needs and some urgently referred people had to wait longer than four hours to be seen.
“We reported our findings to the trust so it knows where it must make improvements, and where there’s good practice it can build on.
“We’ll continue monitoring the trust to ensure people are safe and will return to assess whether improvements have been made.”
Inspectors also found:
- On Silver Birches ward, learning from previous safety incidents wasn’t always shared with staff to make sure people were protected in future
- People’s medicines weren’t always managed safely in the trust’s Enfield crisis services, as they relied on a clinic room in a different building to provide them. The trust resolved this during this inspection by re-opening a closed clinic room
- Staff in the trust’s mental health crisis services and health-based places of safety weren’t always up to date on training needed to keep people safe, such as first-aid and safeguarding.
However:
- Staff supported people to make as many choices as possible in their care. Where people didn’t have the capacity to make their own decisions, these were made in close consultation with people’s families, taking into consideration people’s wishes, culture and history
- People were cared for in clean, safe ward environments. Silver Birches ward included pleasing sensory areas for people with dementia, such as halls painted to look like a street, with people’s bedroom doors painted to look like front doors
- Staff praised their work environment and said they felt comfortable raising concerns.