A north London mental health service’s CQC rating has improved from requires improvement to good, following an inspection undertaken in November.
CQC inspected Camden and Islington NHS Foundation Trust’s acute wards for adults of working age and psychiatric intensive care units to check on the progress with improvements it previously told the trust to make.
In addition to rating the service good overall following the inspection, CQC rated the service good for being effective, caring, responsive to people’s needs and well-led. CQC rated the service requires improvement for being safe.
As the inspection assessed just one service, it was not broad enough to update ratings for the trust, or the Highgate Centre for Mental Health or St Pancras Hospital - which is where the service is based.
Jane Ray, CQC deputy director of operations for London, said:
“I’m pleased Camden and Islington NHS Foundation Trust has made improvements in its acute wards for adults of working age and psychiatric intensive care units.
“The service was more responsive to people’s needs compared to our previous inspection.
“People could now access it when they needed, and collaboration with health professionals from other services meant people could be discharged at the right time to receive appropriate care elsewhere. This has had a positive impact on the lives of those using this service.
“We found people benefited from kind and caring interactions with staff, who developed good plans to support their recovery.
“However, there are issues the trust must address.
“The service faced pressure due to not having enough nurses. While this is an issue affecting much of the NHS, leaders must develop strategies to reduce the impact this can have on people’s care.
“The trust should also ensure staff training is completed so they can support people with the best possible care.
“Following the inspection, we reported our findings to the trust so it can build on what’s going well and address areas needing improvement.
“We’ll continue to monitor the service and the wider trust, including through future inspections, to ensure they continue to meet standards people have a right to expect.”
Inspectors found the service, which is based at the Highgate Centre for Mental Health and St Pancras Hospital, was more responsive to people’s needs compared to its previous inspection. However, there are other areas where additional improvement must be made.
The inspection found:
- Wards were safe and clean. Staff managed risk well, minimised the use of restrictive practices, managed medicines safely and followed good safeguarding practices
- Staff developed recovery-oriented care plans for people, informed by comprehensive assessments. Staff also provided a range of treatments to meet people’s needs in line with national best practice guidance
- Staff evaluated the quality of care they provided
- Ward teams included or had access to the full range of specialists required to meet people’s needs
- Managers ensured staff received supervision and appraisal
- Staff worked well as a multidisciplinary team, and with those outside the ward providing aftercare to people
- Staff understood and discharged most of their statutory roles
- Staff treated people with compassion and kindness, respected their privacy and dignity, and understood their individual needs. Staff also actively involved people, as well as their families and carers in decisions
- The service managed beds well, so that a bed was always available locally to a person who would benefit from admission. People were discharged promptly, once their condition warranted this
- The service was well-led, and processes ensured that ward procedures ran smoothly.
However:
- There were not enough permanent nurses
- Fewer than 75% of staff had completed required training in basic and intermediate life support, however there were plans to address this
- Clinical equipment was not always sufficiently checked to ensure readings were accurate
- Staff did not receive specific training to meet some people’s needs, specifically autistic people and those with learning disabilities, although training was planned
- Staff did not always provide adequate information to people detained under the Mental Health Act about their rights
- The trust did not have clear policies and procedures on how to address abuse towards staff.