CQC - Care Quality Commission

01/16/2020 | Press release | Distributed by Public on 01/16/2020 05:42

Chief Inspector of Hospitals finds improvements have been made but recommends Norfolk and Suffolk NHS Foundation Trust remains in special measures

England's Chief Inspector of Hospitals has recommended Norfolk and Suffolk NHS Foundation Trust remains in special measures following a Care Quality Commission inspection.

The trust was rated Inadequate overall and placed into special measures following an inspection in 2015. The trust was removed from special measures in 2016 then placed back into special measures in 2017. On their return, between 7 October and 6 November 2019, inspectors found the trust had made some improvements, but more improvement is needed and the trust will remain in special measures.

Norfolk and Suffolk NHS Foundation Trust is now rated Requires Improvement overall, Requires Improvement for whether services are safe, responsive, effective and well-led and Good for whether services are caring.

Chief Inspector of Hospitals, Professor Ted Baker, said: 'On our return to Norfolk and Suffolk NHS Foundation Trust we found that improvements had been made in several areas, but more work still needs to be done.

'At our inspection in 2017, we raised concerns about safety, culture and leadership and told the trust it must take urgent action to put things right. Some of these were issues that we first raised with the trust in 2014.

'The trust board and senior leadership team were newly formed. At our inspection in 2018 we had significant concerns about the safety, culture and leadership of the trust. Since then, there had been a change in leadership.

'At this inspection, we found that, although some of the concerns had not fully been addressed, there had been a shift in approach and foundations had been laid to improve the direction of travel. Most staff inspectors spoke with felt more listened to, empowered and believed the trust is moving forwards.

'We saw early improvements in almost all areas and a feeling of optimism from all staff, but there had not been enough time to judge if these changes would be sustained.

'Whilst governance processes had improved, they had not yet fully ensured that performance and risk were managed well. For instance, waiting lists remained high in the specialist children and young people community mental health teams.

'Some stakeholders did not feel that changes had positively impacted all patients, with feedback advising that some still did not feel listened to, with poor communication being a key feature of feedback from patients and their families.

'The trust leadership is aware of the areas where improvements are needed. We have called upon NHS Improvement to continue to support the trust to make the necessary improvements outlined at our inspection. We will continue to monitor the trust closely and this will include further inspections.'

The trust has been told it must make the following improvements:

  • The trust must ensure that the internal and external environments of the learning disability inpatient service are clean, secure, maintained and suitable for the purpose for which they are being used.
  • The trust must review their systems to ensure that patients have risk assessments and care plans in the children and young person service.
  • The trust must ensure adequate staff resources are available to reduce the patient waiting lists for triage, assessment and treatment in the children and young person service and for attention deficit hyperactivity disorder patients.
  • The trust must ensure that contemporaneous records are kept for people who use health- based places of safety. The trust should ensure that medicines audits are robust, and all medication errors are reported and investigated as per trust policy.
  • The trust must ensure that there are enough staff to safely manage the health-based places of safety and to meet emergency referral targets.

Inspectors also found some examples of outstanding practice at the trust. These included:

  • In the acute wards for adults of working age and psychiatric intensive care units, the trust had undertaken a quality improvement programme, steered by the Royal College of Psychiatrists, to reduce the incidents of restrictive interventions and restraints. This was a significant piece of work which has reduced the number of restraints used on the pilot acute wards. This programme has now rolled out to other wards for implementation. The programme involved the patient voice who shared their experiences with staff. This success has been recognised by the Royal College of Psychiatrists who are leading the national programme.
  • In the community mental health services for people with a learning disability or autism, services had liaison staff who attended general practitioner surgeries to ensure that all patients had access to yearly physical health checks and to support general practice surgeries in making their services learning disability friendly. Liaison staff also had good links with the local general hospital to ensure that any physical health interventions were managed effectively.

Full details of the ratings, including a ratings grid, are given in the report published online at: www.cqc.org.uk/provider/RMY


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