The Chief Inspector of Hospitals has told Avon and Wiltshire Mental Health Partnership NHS Trust that it must make further improvements following the latest inspection by the Care Quality Commission (CQC).
A team of inspectors from the CQC visited Avon and Wiltshire Mental Health Partnership NHS Trust during September and October 2018 to check the quality of five core services:
- acute wards for adults of working age and psychiatric intensive care units,
- child and adolescent mental health wards,
- mental health crisis services and health based places of safety,
- specialist community based mental health services for children and young people,
- wards for people with a learning disability or autism.
CQC also looked specifically at management and leadership to answer their key question: Is the Trust well-led?
Avon and Wiltshire Mental Health Partnership (widely known as ‘AWP’) provides mental health services across Bath and North-East Somerset, Bristol, North Somerset, South Gloucestershire, Swindon and Wiltshire. The trust also provides specialist mental health services for a wider catchment extending throughout the south west.
Following this inspection, the trust is still rated as Requires Improvement overall for the quality of its services. The trust is rated Good for being effective and caring, Requires Improvement for being safe, well led and responsive to people’s needs.
Dr Paul Lelliott is Deputy Chief Inspector of Hospitals and the CQC’s lead for mental health services: “I am disappointed at the slow progress that the trust has made in improving the quality of its services. This is particularly the case for the mental health admission wards for adults of working acute wards and the mental health wards for children and young people.”
“In both cases, the trust had not made the improvements that we required them to make following previous inspections – particularly with respect to the safety of the ward environments.”
“It is also a matter of concern that 18 months after it opened, the Daisy Unit [in Devizes] stills lacks a sense of direction. Managers had not set out an appropriate model of care to support people with a learning disability. Staff had not received the appropriate training to ensure they could meet the needs of their patients in their care.”
“The picture is a mixed one; in that the trust has made real improvements to the mental health crisis services and health-based places of safety – which are now rated as Good.”
“Also, during our inspection, we met many staff who were committed to providing safe, compassionate care and inspectors noted an improved staff culture. Staff told us they felt supported and valued by the trust. We will return in due course to check on their continuing progress in improving the services for their patients.”
The Daisy Unit (pictured above) – which provides an inpatient service for people with a learning disability – has been rated Inadequate overall. Inspectors found the model of care was not clear.
There were a high number of physical interventions taking place to manage the behaviour of patients, but there was no plan to reduce the practice. The unit did not have a focus on enabling people to leave hospital and integrate back into the community in line with national guidance and best practice.
The Daisy Unit, which opened in January 2017, is a purpose-built unit and is part of the Green Lane Hospital site in Devizes. Last October the Daisy Unit team received a Highly Commended recognition in the National Mental Health 2018 Awards, which were supported by NHS Improvement. The team had been shortlisted in the Learning Disability and Autism category.