The Care Quality Commission (CQC) has published two reports following an inspection of one of the forensic inpatient and secure wards and the acute wards and for one of the adults of working age and psychiatric intensive care units (PICU) at Hertfordshire Partnership NHS Foundation Trust in October and November.
These unannounced focused inspections were carried out after CQC received information of concern regarding the safety and quality of the services. Inspectors rated the forensic inpatient and secure wards at Warren Court as good overall a drop from the previous rating of outstanding. Caring and well-led also moved from outstanding to good, while safe dropped from good to requires improvement.
The acute wards for adults and PICU had remained rated as good overall, as did the rating for caring. Safe is rated as requires improvement which is a drop from the previous rating of good.
These ratings do not affect the overall rating for Hertfordshire Partnership NHS Foundation Trust which remains as outstanding.
Ceri Morris-Williams, CQC deputy director of operations in the East, said:
“On the whole we saw people being provided with good care on these wards, and we saw a workforce doing their best to ensure people’s needs were met.
“However, we found some issues that the trust recognised and know they need to take action on and it was reassuring that leaders responded to the points we also raised and already had plans in place to make changes and improvements in the areas we highlighted.
“We will continue to monitor the trust, including through future inspections, to check on the progress of these improvements.”
In the forensic inpatient or secure wards inspectors found the following during this inspection:
- Inspectors saw staff were caring, kind and discreet in working with the people who use the service. They provided people with help and emotional support
- People using the service were supported by staff to attend specific activities and engage with services that could help them. For example, there were online courses available to attend and the staff would support them to engage in these
- Most of the houses which made up the ward were clean, well equipped, well-furnished and fit for purpose. However, one house did need decoration, but the trust consulted people using the service and there were plans in place to redecorate the house.
However,
- People receiving care said they did not receive one to one sessions with their nurses as they were too busy doing other things
- People using the service said they were often bored as there was a lack of activities and staff were too busy doing other things to spend time with them.
In the acute wards for adults of working age and PICU inspectors found the following:
- Staff made sure patients understood their care and treatment and found ways to communicate with patients who had communication difficulties
- The ward used regular bank and agency staff to cover vacancies, which meant there were enough staff deployed on the unit
- Staff carried out regular safety audits of the environment
- Inspectors saw a number of positive interactions between staff and people
- Staff were supporting one patient to develop and display some artwork on the ward
- People had easy access to an independent advocate, who visited regularly.
However:
- People told inspectors that some staff were unwilling to talk to them about their sexuality
- Another person said that some situations with other people “escalate unnecessarily," because “staff don’t listen to people and resolve things quickly.”
- Despite inspectors seeing evidence of staff treating people with dignity and respect during the inspection, some people said that not all staff were kind and caring in their responses. This meant they did not always feel listened to and involved in their care.