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West Midlands trust improves rating to ‘good’, but told to fill vacancies by regulator

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A mental health and community provider with nurse vacancy rates in some teams as high as 26% has been rated “good” overall by inspectors, while also being told to fill empty posts.

The Care Quality Commission found an average of 14.6% of nurse posts were empty when it visited Black Country Partnership NHS Foundation Trust in October 2016.

“While we found good and outstanding practice, we also found some areas where the trust needed to make further improvements”

Paul Lelliott

But some areas were worse than this, with acute and psychiatric intensive care unit wards seeing a 26.7% nurse vacancy rate, specialist community mental health teams for children having 21.1% positions empty, and crisis teams operating with 19.1% of posts unfilled.

Meanwhile, the number of vacancies among nursing assistants was higher. Across the trusts there were 16.9% of these posts unfilled on average, said the CQC.

But again, in some teams the situation was worse – 33.6% of posts were empty in specialist community mental health for children, and 31.2% were unfilled in community mental health teams for adults.

Learning disability wards, wards for older people, and crisis teams were also all experiencing vacancy rates for nursing assistants of more than 20%.

In its report on the trust, the CQC said the organisation should ensure specialist community mental health teams for children and young people filled vacant posts.

However, it also noted a number of positive changes since its last inspection a year before, in November 2015, when it was rated “requires improvement”.

“Modern matrons had been introduced to the trust, which staff said had a positive impact”

Paul Lelliott

The regulator found the organisation had recruited more staff to health visiting teams, to ensure patients received appropriate and safe care and treatment, and had reduced vacancies in acute wards for adults.

The introduction of eight modern matrons had also “strengthened nursing leadership across the trust” and improved quality and safety in “a number” of areas, such as embedding the use of risk assessments, said the CQC.

The number of people receiving mandatory training across trust had also improved, from around 59% in 2015, to 82% at the latest inspection.

The training course with the lowest compliance rates was safeguarding adults at level 3, with 66% of staff having completed it – but this was still an improvement on the 26% who had received such training in 2015.

CQC deputy chief inspector of hospitals and mental health lead, Dr Paul Lelliott, said: “We were impressed by the trust’s response to our previous inspection and found a number of improvements had taken place.

Care Quality Commission

Dr Paul Lelliott

Paul Lelliott

“Our inspectors found the quality and consistency of risk assessments and care plans had improved, the trust was effectively engaged with patients, carers and staff and staffing levels had improved across its services,” he said.

“Modern matrons had been introduced to the trust, which staff said had a positive impact. We were impressed by feedback about the carers group and the work it had undertaken to support families of people living in Sandwell with mental health problems,” he said.

Dr Lelliott also noted the CQC had rated the trust’s community mental health teams for adults and specialist community mental health teams for children as being “outstanding” for providing caring services.

“While we found good and outstanding practice across the trust, we also found some areas where the trust needed to make further improvements. We have highlighted these to the trust and its leadership is aware of what it needs to do to ensure those improvements take place,” he added.

The Black Country Partnership NHS Foundation Trust provides mental health services in Sandwell and Wolverhampton, learning disability services in Sandwell, Wolverhampton and Walsall and children’s community services in Dudley.

In a statement provided to Nursing Times, the trust said vacancy levels had improved since the CQC inspection - from an average of 14.6% to 12.17% for nurses, and from an average of 16.9% down to 7.84% for nursing assistants.

The trust’s interim director of nursing, allied health professionals and governance, Joyce Fletcher, said: “Patient safety is a top priority for the trust, and is something that we monitor at trust board.

“The level of vacancies quoted in the CQC report relates to 2015/16 and the picture now is very different because we have introduced a number of initiatives.”

She said these included developing a clinical apprenticeship scheme to encourage people into healthcare support worker roles, new recruitment and retention and health and wellbeing strategies, and taking part in the nursing associate pilots.

In addition, the trust had secured additional funding for extra posts in its child and adolescent mental health services, which had resulted in a “significant reduction” in vacancies, said Ms Fletcher.

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