'Too much poor care' in mental health providers

The regulator has published its first comprehensive analysis of the mental health sector today, using the inspection reports of the 54 NHS mental health providers and 87 independent providers.

The watchdog found that despite examples of “excellent care” there was “too much poor care and far too much variation in both quality and access across different services”. It said this was a concern due to rising demand and staff shortages across the sector.

CQC deputy chief inspector and lead for mental health Paul Lelliot said the watchdog was concerned about the variation in how staff physically restrain patients.

In the report’s forward, Dr Lelliot said the CQC will be “strengthening” its policy on how and how often restraint should be used.

He added: “We are concerned about the great variation across the country in how often staff physically restrain patients whose behaviour they find challenging.

“In response to this, the CQC is further strengthening its assessment of how and how often services use physical restraint; we wish to send a clear message to providers that we will be subjecting services where staff frequently resort to restrictive interventions to much tougher scrutiny.”

HSJ understands the CQC will consult with partners to update its policy.

The report flagged up out of area treatment, particularly for patients in locked rehabilitation wards, as a concern as well as safety and access to clinical information.

The CQC’s biggest safety concerns were poor physical environments on many wards, staff shortages and staff not managing medicines safely.

The report also found:

• 74 per cent of core services provided by NHS trusts and 75 per cent of independent mental health locations were rated good or outstanding.
• 97 per cent of NHS providers and 98 per cent of independents were rated good or outstanding for having caring and compassionate staff.
• But 40 per cent of NHS core services and 39 per cent of independent core services were rated requires improvement or inadequate for safety.

The CQC said providers need to:

• involve patients more in their own care;
• invest in better local services to reduce out of area placements;
• invest in better IT systems; and
• for leaders to support staff to work to “their full potential”.

Dr Lelliot said the sector is at a “crossroads” between a future where people have high quality care close to home, or services being rooted in the past.