CQC recommends ‘inadequate’ trust goes into special measures

Inspectors also downgraded SHSC overall from “requires improvement” to “inadequate”, after visiting the trust between 7 January and 5 February. The community and mental health trust was rated “inadequate” in the well-led and safe domains, “requires improvement” for effective and responsive and “good” for caring in a report published today.

The trust’s wards for older people with mental health problems dropped two ratings from ”good” to “inadequate”. The report noted this service did not have enough nursing and medical staff who knew the patients and received basic training to keep people safe from avoidable harm.

The CQC also found the trust did not always provide consistently safe care, staff had used non-approved restraint techniques on one ward and care plans were not “entirely person centred and recovery orientated”.

The regulator said there continued to be “systematic issues within the culture” and trust governors reported they felt “unheard and undervalued”.

Staff also reported incidents of bullying and the CQC described “pockets of culture” within the trust that were not caring and compassionate.

Parts of the trust estate were deemed not fit for purpose. For example, dormitory accommodation remained in use and not all seclusion areas were comfortable and dignified.

The CQC found 47 breaches of legal requirements, and issued one warning notice and eight requirement notices.

CQC deputy chief inspector and lead for mental health and community services, Kevin Cleary, said: “We found there had been a deterioration in the trust’s services since our last inspection, with many areas previously highlighted for improvement having not been fully addressed. We found continuing problems with poor culture in the trust where staff felt undervalued and some care was delivered in an unsafe manner and risked patient safety.”

“However, staff were working well together and supporting each other, and developed effective relationships with other teams across to the trust and local healthcare services in the community to benefit patient care,” he added.

Jan Ditheridge, the trust’s newly appointed chief executive, said “Even in the short time I have been in post it is obvious to me that we have already improved, we will improve further.”

Ms Ditherage added: “I base this on the fact that everywhere I go in our organisation, I find committed, caring and compassionate staff who are focused on improving standards of care for our service users, their families and carers.”

The trust noted some measures to improve its services have already been implemented, which included strengthening of staffing arrangements on the acute mental health wards and psychiatric intensive care unit and making sure clinical supervision is available and accessed by all clinical staff.

Earlier this year, SHSC received a warning notice from the CQC, which accused its leaders of being too “removed” from front-line issues and not being alert to high-risk restraint practices.