A mental health provider in the West Midlands has been told by regulators to improve on staff training, particularly around the rights of patients.
Services provided by Dudley and Walsall Mental Health Partnership NHS Trust have been rated as “requires improvement”, following an inspection by the Care Quality Commission.
“We were concerned that the trust was not always doing all that it could to ensure that patients and staff were safe”
The CQC inspected the core services provided by the trust in February, giving it an overall rating of “requires improvement”.
It was rated as “good” for being caring, responsive and well-led but “requires improvement” for being safe and effective.
The CQC has told the trust to take action in several areas, including that staff must explain patients’ rights under the Mental Health Act and record it consistently in care records.
In addition, the trust must ensure staff are aware of the rights of informal patients and they are not routinely delayed from leaving the acute ward, said the CQC in its report.
Risk assessments must contain detailed and consistent information about the risks of people using their services, while care plans must be completed and be “recovery oriented”, it added.
The regulator also said statutory and mandatory training compliance must be monitored regularly and outstanding areas of non-compliance must be addressed.
It added that clinical supervision and appraisal must be consistent with the guidance of the provider’s policies and staff must record it accurately.
However, the CQC inspection team also highlighted a number of areas of good practice.
“Although we are disappointed with the final rating, the report highlights many areas of good practice”
For example, the manager of the trust’s Kinver ward had led the development of two clinical practice initiatives to support safe and quality care on the adult acute wards, including a toolkit with alternative strategies and sensory techniques for patients with a history of self-harming.
The same manager had also developed a personality passport, which used self-management techniques to help patients with a diagnosis of personality disorder develop plans for use in crisis.
In addition, the CQC noted that the child and adolescent mental health service team were “proactive and forward” thinking in their approach to service delivery and improvement.
For example, staff were involved in audits monitoring different areas of their work, such as deliberate self-harm trends, which had led to the development of specific groups for young people on dealing with exams, anxiety management and anger management.
CAMHS services were also working with a company to develop a mood diary “mobile app” for children and young people to use.
Across all older people’s inpatient wards, staff delivered a high level of care to both patients and relatives, including a holistic personalised approach to discharging patients, said the regulator.
Dr Paul Lelliott
Dr Paul Lelliott, CQC’s deputy chief inspector of hospitals and lead for mental health, said: “Our inspectors found the trust must make a number of improvements to bring its services up to a level that would earn a rating of ‘good’ overall.
“In particular, we were concerned that the trust was not always doing all that it could to ensure that patients and staff were safe,” he said.
“In some parts of the service, staff did not regularly update risk assessments in light of changes in a patient’s condition. Also, staff did not always follow best practice in storing, transporting or administering medicines,” he said.
Mark Axcell, the trust’s acting chief executive, said: “We welcome the feedback from the CQC and, although we are disappointed with the final rating, the report highlights many areas of good practice and includes some positive feedback from inspectors, staff, patients, carers and stakeholders.
“Quality and safety remains our top priority and we have already taken action to address some of the points raised,” he said.