The Care Quality Commission (CQC) has told Essex Partnership University NHS Foundation Trust significant improvements are needed on two of their acute wards for adults of working age following an inspection in October.
The inspection was carried out on these two wards because CQC received concerns about the safety and quality of the services in those particular areas.
Following the inspection CQC issued a letter of intent to the trust. CQC asked the trust to submit information by 11 October 2022 demonstrating how they would effectively manage patient care.
Following the review of the action plan CQC wasn’t fully assured and served the trust with a warning notice to ensure the significant concerns found were addressed. These included:
- Patient observations
- Staffing
- Blanket restrictions
- Ensuring patient consent
- Recording and reporting of incidents.
In October last year, CQC suspended the ratings for the acute wards for adults of working age. At that same time CQC also suspended the ratings for the psychiatric intensive care units but these weren’t looked at on this inspection. They will both remain suspended until a full inspection is completed.
Ceri Morris-Williams, CQC deputy director of mental health in the east of England, said:
“Our inspection into the acute wards for adults of working age at Essex Partnership University NHS Foundation Trust raised some very serious concerns about people’s safety.
“Staff weren’t always following the trust’s own policies regarding people’s observations. Patients told inspectors they had seen staff falling asleep while they were on duty. Our inspectors reviewed data and found two instances where staff were reported to be asleep while undertaking observations.
“We also found blanket restrictions in place which stopped people from accessing the gardens, bedrooms, bathrooms and toilets this is unacceptable. Leaders need to find ways to give people the basic freedoms they are entitled to whilst keeping them safe.
“We were concerned enough that at the inspection we told the trust we would be proceeding with enforcement action if they didn’t assure us that rapid improvements were being made on these wards.
“The plan they submitted to us, didn’t provide the reassurance we needed, so we issued them with a warning notice to focus their attention to the areas where we want to see immediate and significant improvements.
“Due to our concerns, we have suspended the ratings for this service and that will remain the case until we publish the findings of our most recent, full inspection which took place in January.
“We’ll continue to monitor the service very closely to ensure people are safe and that improvements are made and fully embedded. If the required improvements are not made in a timely manner, we won’t hesitate to take further action to keep vulnerable people safe.”
Inspectors found the following:
- Staff did not always follow the Trusts’ policies and procedures with regards to recording and reporting of incidents. Staff knew what incidents to report and how to report them. However, out of the seven records reviewed, inspectors found three examples of incidents recorded within people’s notes that had not been reported on the Trust reporting system
- There were very high levels of vacancies across both wards. This meant that there were many different temporary staff working on the wards that were not familiar with people. At the time of inspection, the vacancy rate for registered nurses was 81% (Willow ward) and 56% (Galleywood ward)
- The trust had not ensured that work was completed to address blind spots where staff couldn’t see people
- The trust had not ensured that all aspects of care and treatment of people was provided with the consent of the person
- The storage of ligature cutters differed on the two wards. On Willow ward all ligature cutters were stored in one bag. On Galleywood ward the different cutters were placed in individual bags in the nursing office. This was not in line with trust policy. Differing practice across the two wards could lead to staff being confused about the process for accessing these in an emergency.