• Patients obliged to sleep on sofas or mattresses because of pressure on services
  • “Surge beds” used daily - for up to a week at a time
  • Community learning disabilities services rated ‘outstanding’

Oxleas Foundation Trust, a well regarded mental health and community provider, has been rated as “requires improvement” by the Care Quality Commission following an inspection in April.

The trust provides a wide range of mental health and community care services across south east London, and into Kent. It has generally been well regarded. Its previous chief executive Stephen Firn retired from the post in the spring and took up a part-time national role with NHS England.

The trust was rated as good for being effective, caring and responsive to people’s needs; but requires improvement in both the safe and well led domains.

Staff at the trust told the CQC team that patient numbers had put services under intense pressure. On three occasions the pressure for beds meant that patients were obliged to sleep on sofas or mattresses for one night until a bed became available.

Over-flow beds known as “surge beds” were used daily, with records showing that some patients remained in the surge bed for between two days and a week.

Pressure for beds was so intense that beds for patients on leave were sometimes used for new admissions. Staff were also obliged to move patients between wards and locations to accommodate new admissions.

The CQC report said: “In the mental health acute care wards, it was clear that problems with patient admissions and the management of beds need to be addressed.”

Ben Travis, chief executive for Oxleas Foundation Trust, said: “The pressure on mental health beds has been widely recognised and the CQC report acknowledges that we have been seeking solutions - but highlights that more needs to be done and we are committed to solving this issue.”

Further concerns were raised by the CQC about safety: some wards had fixtures and fittings that people at risk of suicide could use as a ligature anchor point. These potential risks had not been adequately assessed and addressed, the CQC report said. Nor did the seclusion room on one of the wards meet the guidance set down by the Mental Health Act Code of Practice, the report said.

Mr Travis said: “Ligature assessments are already carried out in all areas in our mental health units where patients may be alone and we remove, or manage, all ligature risks in these areas. However, we have now carried out ligature assessments in all communal areas of our inpatient units and will be extending this across our buildings where our community health mental health teams are based.”

The CQC report found much to praise: “The trust can be proud of many of the services that it currently manages. Staff were caring and patient focused with a good understanding of their individual needs. In the community learning disabilities service, which we rated outstanding for caring, we observed a culture that was always person-centred, with highly motivated staff. Staff supported people in innovative ways to be active and equal partners in their care.”