ENGLAND’S chief inspector of hospitals has rated the services provided by Worcestershire Health and Care NHS Trust as Good overall following a focused inspection by the Care Quality Commission (CQC).
The trust provides mental health and primary care services across all age groups. Across Worcestershire, the trust provides community care, specialist primary care, adult mental health, learning disabilities, and paediatric and mental health care for children, young people and their families.
The CQC inspected acute wards for adults of working age, community mental health services for children and adolescents, long stay rehabilitation mental health wards for adults of working age and community mental health teams for adults of working age and early intervention services.
These four core services were rated as Requires Improvement following the trust’s first comprehensive inspection in January 2015. Inspectors returned to inspect these areas in November 2015 and in June 2016 where improvements were noted in all areas, resulting in an overall rating of Good.
Full reports for each core service are available at: http://www.cqc.org.uk/provider/R1A
Inspectors rated the care provided by staff to be Good regarding whether services were effective, caring, responsive and well-led and rated it as Requires Improvement regarding whether services were safe.
CQC’s deputy chief inspector of hospitals (and lead for mental health), Dr Paul Lelliott, said: “Overall, Worcestershire Health and Care NHS Trust provides good care to the population it serves and we were encouraged by the improvements made following our last inspection. The trust can be proud of many of the services that it manages and the hard work has paid off resulting in a new overall rating of Good.
“We found staff to be dedicated, kind, caring and patient focused. The community mental health teams for adults of working age and early intervention services deserve particular recognition for the quality of the care and treatment offered and for how responsive they are to the needs of the people they serve.
“Urgent cases would be dealt with by the crisis teams and non-urgent referrals would be referred to community mental health teams. Overall, the management of referrals had improved in Worcestershire, leading to a consistent approach across community teams.
“The trust implemented an electronic care records system county wide. This had improved access for staff to patient information, including out of hours. Storage of information had improved with most notes transferred to the electronic system.
“Worcestershire Health and Care NHS Trust is a large organisation and we found some areas where improvement could be made. The trust has told us they have listened to our inspectors’ findings and we are confident that the executive team, with the support of their staff, will work to deliver these improvements on behalf of all of their patients. We will return in due course to check on the progress that they have made.”
The reports highlight several areas of good practice across the four departments, including:
• Inspectors noted improvements in the way staff managed risk to patients who may harm themselves in the acute wards for adults of working age and the psychiatric intensive care unit.
• Staffing levels had increased and there was a clear and effective leadership structure.
• A single point of access was embedded county wide meaning referrals were triaged quickly and young people in crisis were supported quickly.
• Staff had a good understanding of how to identify and report safeguarding concerns.
• In the community mental health services, patients had access to, and were referred to specialised mental health services when clinically appropriate (eg. eating disorder services).
• Staff and patients worked well together and treated each other with dignity and respect.
• Patients in the long stay rehabilitation wards were involved in their care planning and reviews and met regularly to discuss any issues. Patients had a varied programme of activities and we saw a culture of recovery at the unit.
• There was good collaborative working within the multi-disciplinary teams and good partnership working with external agencies to support the recovery of patients.
Inspectors said that the trust must improve in some areas, including:
• There were still some concerns relating to the safety of patients and staff. For example, ligature risks in two units and the alarm system in one unit required improvement to ensure the safety and wellbeing of all.
• In the community and mental health services for children and adolescents, some young people had to wait over 25 weeks for specialist psychological treatment.
• Although there was improved monitoring of waiting times to see a psychologist, 41 per cent of patients had to wait over 18 weeks in the community mental health teams for adults of working age and early intervention services.
The trust provides the following core services:
• Acute wards for adults of working age and psychiatric intensive care units
• Community-based mental health services for adults of working age
• Child and adolescent mental health wards
• Community mental health services for children, young people and families
• Community-based mental health services for older people
• Wards for older people with mental health problems
• Mental health crisis services and health-based places of safety
• Community mental health services for people with learning disabilities or autism
• Long stay rehabilitation mental health wards for working age adults
• Adult social care
• End of life services