Monitor takes more action at Dorset Healthcare

The regulator first intervened at the community and mental health services provider in April, compelling the board to sign undertakings committing to address the concerns and commission an independent review of governance.

After receiving the independent review from Deloittes, Monitor became concerned the trust was not acting quickly enough. On Tuesday it announced it had imposed a condition on the trust’s licence requiring it to ensure its board and council of governors are functioning “effectively”.

Explaining its reasoning in a notice of additional licence condition, Monitor said the independent review had identified “serious governance failings”.

The notice also highlighted the trust was yet to address all of the Care Quality Commission’s concerns about care at the Forston Clinic which were first highlighted in December last year.

When CQC inspectors visited in August they found the 13 bed mental health inpatient unit was still failing standards on staffing and reacting to risks to quality.

Concerns that the trust was failing to address these issues sparked Monitor’s original intervention in April. The grounds for the enforcement undertakings included a failure to “triangulate quality information”. This led to action plans for improvements at Forston clinic being signed off incorrectly and the trust twice providing “incorrect assurance” to Monitor and the CQC.

The grounds also highlighted the fact similar quality concerns had been found at Blandford Community Hospital as evidence the trust board had not learnt lessons from failings at Forston.

Another major issue was the trust’s failure to carry out “appropriate due diligence” before taking on community services assets from Dorset, Bournemouth and Poole primary care trusts in 2011. The notice said the trust had “underestimated the complexity of the acquisition”.

Chief executive Paul Sly, who was previously chief executive of the Dorset PCT cluster, said the trust had recently recruited an additional 135 whole time equivalent staff.

He said: “We’ve been working hard to make changes to our quality and governance systems to help raise standards across all the trust’s services.

“Change doesn’t happen overnight but there are clear improvements – in particular to our mental health inpatient services at Forston Clinic – since Monitor’s first intervention in April.”