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Care improving at Broadmoor though nurse vacancies ‘significant’

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Efforts to recruit and retain more nursing staff have seen improvements to care provided to patients at Broadmoor Hospital, according to regulators, prompting the removal of a warning notice.

There had been an increase in therapeutic activities following the recruitment of more nursing staff at the high security psychiatric hospital in Berkshire, said the Care Quality Commission.  

“The trust had taken significant steps to improve nurse recruitment”

CQC report

The CQC re-inspected Broadmoor in July 2017, after its inspectors had identified breaches in the care provided there by West London Mental Health NHS Trust during a visit last November.

The CQC had issued a warning notice requiring the trust to improve patient access to therapeutic activities, especially for patients who were confined to their rooms at night.

Following the latest visit, the notice has now been removed because inspectors found that the hospital had improved the amount of activities offered to patients each week.

“Having permanent staff is important in delivering high quality care”

Paul Lelliott

This was because the trust had improved its recruitment strategy, resulting in extra staff being joining, noted the regulator.

“As of 2 August 2017, an additional 56 nurses had been given starting dates in 2017. This meant that the trust had taken significant steps to improve nurse recruitment,” said the CQC’s latest report.

It added: “We found that on 2 August 2017, there were 50 vacancies for qualified nurses on the wards at Broadmoor Hospital. In November 2016, we found that there were 68 vacancies.”

It also observed that the focus was not only on recruitment but also on looking at ways to improve retention rates for staff at the hospital.

“These included ‘new starter’ forums so that nurses at the beginning of their careers in the hospital had opportunities to meet with senior management,” stated the CQC.

“The trust had also worked with local housing associations to identify affordable local accommodation for staff as well as providing enhanced relocation packages,” said the regulator.

“We have put in place a wide range of improvements to attract more clinical staff to the trust”

Carolyn Regan

The trust provided the CQC with latest information about its nurse turnover rate, suggesting a “slight improvement” in staff retention.

Between 1 July 2016 and 30 June 2017, the average turnover for ward-based nurses was 15%. In contrast, the rate had been 22% in the year before the previous inspection in November 2016.

The CQC also noted that reported incidents relating to staff shortages had decreased since the previous inspection, and that the proportion of shifts with the appropriate number of nursing staff allocated had “increased considerably”.

However, a third of the patients that inspectors spoke with still raised concerns about the staffing levels at the hospital, according to the CQC’s report.

Care Quality Commission

Dr Paul Lelliott

Paul Lelliott

The report stated: “At the time of the inspection in November 2016, there were significant gaps in the availability of registered nurses and that this had an impact on the care delivered in the hospital.

“At this inspection, we found that while there were still significant gaps, the service had made considerable effort to employ more staff and that this was beginning to lead to improvements in the outcomes for patients,” it concluded.

Paul Lelliott, the CQC’s deputy chief inspector, said: “Most patients we spoke with were positive about the support provided in the hospital and some told us that there had been an improvement in access to activities since our previous inspection in November 2016.”

But he added: “While there had been considerable work undertaken to recruit additional nurses in the hospital, there were still significant vacancies.

“We recognise that it is challenging for the trust to recruit nurses to work at Broadmoor, but having permanent staff is important in delivering high quality care,” he said.

Carolyn Regan, chief executive of West London Mental Health NHS Trust, said the re-inspection at Broadmoor recognised the “significant improvements we have put in place to improve staffing levels and the positive impact this has had on patient care”.

West London Mental Health NHS Trust

Broadmoor trust’s nurse staffing problems remain

Carolyn Regan

She said: “We have put in place a wide range of improvements to attract more clinical staff to the trust and support them in post, including the Capital Nursing development programme, access to learning and development opportunities, a buddying system for new starters and incentives for existing staff to enrol on the trust’s temporary staff bank employment system.

“Retaining staff who are already with us is also a priority and that is why we have enhanced our programme of development opportunities for staff, and now actively celebrate the long service of staff who stay with us for longer than 10 years,” said Ms Regan in a statement.

“We know that the improved position on staffing means staff can spend much more time with patients delivering therapeutic activities,” she said. “In fact, our latest figures show that the vast majority of patients are now offered 25 hours or more therapeutic activities per week.

“Clearly we have more work to do to continue to embed improvements but staff at Broadmoor Hospital can be rightly proud of the great progress made so far.”

Broadmoor Hospital is one of three high secure hospitals in England, providing around 200 beds for men who require care and treatment in the conditions of high security.

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