The Care Quality Commission (CQC) has told Black Country Healthcare NHS Foundation Trust, it must make improvements following an inspection in February of their acute wards for adults of working age and psychiatric intensive care units (PICU).
An unannounced inspection of the service was carried out following reports of safeguarding incidents which were being investigated by the local authority and police at the time of inspection.
Following the inspection, the overall rating for the service has moved down from good to requires improvement. The areas of effective, well-led and responsive have also moved down from good to requires improvement, caring remains as good and safe remains requires improvement.
Andy Brand, CQC’s deputy director of operations in the midlands, said:
“When we inspected this service, whilst we saw a strong and supported workforce that felt proud to work for the trust, some improvements were needed to ensure people were receiving appropriate care.
“It was concerning that people sometimes had their escorted leave or activities cancelled and some wards didn’t have enough occupational therapists or activity staff. This meant people didn’t receive the treatment they needed to support their discharge from hospital, or have their wellbeing needs met.
“In addition, people’s care plans weren’t always updated or reviewed effectively which impacted the care they received. We saw examples where people’s health needs or medication had changed but nothing had been noted in their plan meaning staff wouldn’t be delivering the correct care.
“However, we did also see some positive areas of care. For example, people told us staff were very caring and always treated them with respect. Relatives said staff were helpful and kept them updated regularly on their family member.
“We also noted that staff assessed and managed risk well and minimised the use of restrictive practices on people. Staff also knew about any potential ligature anchor points that people could use to self-harm and mitigated these risks to keep people safe.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people can receive safe and appropriate care.”
Inspectors found the following during this inspection:
- The service didn’t always have a bed available for someone who would benefit from admission and patients were not always discharged promptly once their condition warranted this
- Some people didn’t have one to one time with their named nurse
- The ward teams didn’t always have access to the full range of specialists required to meet people’s needs
- Ward staff didn’t always work well together as a multidisciplinary team and with community teams and external providers
- The trust had not trained all staff in immediate life support.
However:
- People said staff were kind, caring and interested in them, they said staff knocked on their door before entering and treated them with respect
- Staff followed good practice with respect to safeguarding
- The trust had reduced the staff turnover rates across the wards
- Staff engaged in clinical audits to evaluate the quality of care they provided
- Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.