Devon Partnership NHS Trust has been told it must make improvements to some services, following an inspection by the Care Quality Commission.
Overall, the trust has been rated as “requires improvement” for providing safe and effective services, and rated “good” for being caring, responsive and well led.
Devon Partnership “requires improvement”, says CQC
The trust is the main provider of mental health services in Devon, with acute inpatient services in Exeter, Barnstaple and Torbay. Its community mental health teams are situated throughout Devon.
The CQC visited hospitals and community services provided by Devon Partnership during July and August 2015.
Inspectors concluded that the trust had made significant and positive changes since its last comprehensive inspection in 2014.
They assessed the services provided in all mental health wards for adults of working age, for older adults and for people with learning disability, long stay rehabilitation wards and forensic secure services.
They also visited community mental health services for adults of working age, older people and people with learning disability teams and the crisis intervention services and the health based place of safety provision.
Community-based mental health services were rated “good”, as were the forensic secure wards, which were rated “outstanding” for their responsiveness.
“While we found that staff were caring and respectful of the patients, the quality of clinical care was not consistently high across all services”
However, the mental health crisis teams did not offer a comprehensive, round-the-clock service and was rated as “requiring improvement”, said the CQC in its new set of reports on the trust.
They did not always have enough staff to assess a new patient promptly and after 9.30pm the only crisis response was a night nurse practitioner, available by phone.
Meanwhile, some wards were unsafe in their design and in the way in which staff managed the risks that this posed, said inspectors.
They were particularly concerned by Haytor ward at Torbay Hospital, and Moorland and Ocean view at North Devon District Hospital, which contained ligature anchor points.
Staff had identified some of these ligature points but had not taken appropriate action to deal with the risks, according to the CQC.
Difficulties in recruiting staff were affecting patient care, noted the regulator.
“On the whole, this is a balanced and fairly accurate assessment of where our organisation was six months ago”
In some services, 30% of posts were vacant. This was a particular problem in forensic services where both staff and patients raised concerns about staffing levels.
However, staff were found to be caring, compassionate and kind with patients and carers reporting that they were treated well.
Dr Paul Lelliott, CQC deputy chief inspector of hospitals and lead for mental health, said: “While we found that staff were caring and respectful of the patients, the quality of clinical care was not consistently high across all services.
“Medical and nursing staff at the Cedars, Haytor ward and in the community mental health services for older people did not assess or monitor the physical health of patients adequately, and many patients did not have easy access to psychological therapies,” he said.
“We rated acute wards for adults of working age as requires improvement because, although the trust had identified the risks posed by the ward environment, they had not addressed them. On one ward, patients told us that they felt that staffing levels were too low,” said Mr Lelliott.
“We are committed to working with the trust to address the issues identified by the CQC”
He added: “It is clear that there have been real improvements since the last inspection, although the trust recognise there are still further changes to be made. The board has a clear strategy for improvement that has been thought through carefully.”
Trust chief executive Melanie Walker said: “On the whole, this is a balanced and fairly accurate assessment of where our organisation was six months ago. We have made a huge amount of progress since last summer and the CQC has recognised that our direction of travel is very positive.”
Dr Paul Lelliott
Dr Stephen Miller, clinical lead for mental health for NHS Northern, Eastern and Western Devon Clinical Commissioning Group, said: “We are pleased to see that Devon Partnership NHS Trust has been rated as ‘good’ in the areas of being caring, responsive and well-led.
“We acknowledge the considerable work done since the last CQC inspection,” he said. “We are committed to working with the trust to address the issues identified by the CQC, and to support the continuous improvement of mental health and learning disability services for the people of Devon.”