• CQC finds some hospital wards run by Coventry and Warwickshire Partnership Trust “did not provide a safe environment”
  • Finds “high level of use” of face-down restraint despite CQC warnings from 2014
  • Trust says it has “moved very quickly” to address any risks posed to patients

QUALITY: Eleven month waiting lists, high levels of restraint and out of date medicine have been experienced by patients with mental health conditions in the Midlands.

A Care Quality Commission inspection of Coventry and Warwickshire Partnership Trust, which provides inpatient and community mental health and learning disability services, found that some of its hospital wards “did not provide a safe environment”.

Across two hospitals and one community centre that was reviewed, the trust was criticised for:

  • Patients being subjected to a continued “high level of use” of face-down restraint and a lack of a follow-up safety checks by doctors, despite the CQC warning the trust about its concerns in 2014.
  • An “unacceptable number of ligature risks” on its acute wards, compounded by blind spots where staff could not observe patients.
  • Using bottles of medication that were out of date and leaving drugs unsecured around people with learning disabilities, breaches that staff “could not account for”.
  • Long waiting times to access community services, with 117 young people waiting 6-11 months to access treatment from CAMHS and a further 138 waiting up to 24 weeks.

The inspection, which took place in April, also found multiple incidences of poor record keeping with patients not being told of the right to an independent mental health advocate or automatically being referred to one if they were found to lack mental capacity. The CQC uncovered further errors on treatment consent forms, prescribing plans that were “invalid” as they didn’t adhere to pre-agreed treatment plans and examples where Ministry of Justice conditions for treatment of patients with a criminal history were not recorded in care plans.

Concerns were also voiced over the high level of staff vacancies across the trust. It found vacancy levels running at 24 per cent for CAMHS community nurses, 18.5 per cent on mental health learning disabilities wards, and acute mental health wards filling over 2,500 shifts with bank and agency staff in the last year. The CQC did however praise the trust for having staff that “treated patients with care and respect and commuicated in ways patients understood”, as well as for recognising and managing the physical health needs of patients.

The CQC has issued four notices requiring the trust to take action against regulation breaches around safe care, dignity, good governance and staffing.

Trust chief executive Simon Gilby said: “Whilst we recognise and accept key areas for improvement identified in the report there are also a huge number of positive areas identified. We are a learning organisation so we take this as constructive feedback and welcome input from the CQC but we also need to clearly work on the issues identified.

“We have done an immediate comprehensive audit and moved very quickly on anything that might pose a risk [to patients].

“There are still issues around how our clinical staff approach [prone restraint] and that specifically is an area we need to continue to make progress in.”

He also told HSJ the trust is in talks with commissioners to address capacity issues and works hard to risk assess patients waiting for treatment.