Wiltshire’s mental health service provider told it must improve

 

The Care Quality Commission has today (September 18) published reports following its inspection in June of the Avon and Wiltshire Mental Health Partnership NHS Trust (known as AWP.)  It has told AWP – which provides adult mental health services for Wiltshire – it must take significant steps to improve the quality of their services.

The CQC sent a team of 70 who spent four days inspecting 39 wards and 27 community services, as well as other specialist services, across Bristol, Wiltshire, Swindon, South Gloucestershire, North Somerset and Bath and North East Somerset. Four warning notices have been issued – each requiring urgent attention.

Overall, the CQC inspection team found that staff were kind and caring and were skilled in the delivery of care.   Inspectors noted positive examples of staff providing emotional support to people in challenging conditions.

However, they had a number of concerns about patient safety. The design of some wards made it difficult for staff to observe vulnerable patients and some wards had ligature points that could endanger people at risk of suicide. There were also wards where male and female accommodation was not fully segregated.

They also noted significant staff shortages on some wards that may have affected patients’ care and safety.   



There were also times when beds were not available.  This meant that adults of all ages in need of inpatient care were sometimes admitted to a ward a long way from their home. 

The CQC identified 32 areas where the trust must improve.  But they also published a list six areas of good practice within AWP.

The Deputy Chief Inspector of Hospitals at the CQC, Dr Paul Lelliott, said that AWP “has room for improvement in many areas.  It is a big trust – with an important job to do.   Many thousands of people depend on its services.”

“On our inspection, we found staff treating patients with respect and communicating with them effectively.  People we met during our inspection were mainly positive about the staff and felt they made a positive impact on their experience on the wards.”

“Frontline staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments.”

It is however difficult to know what the current situation is at AWP.  The June inspection was followed by a ‘quality summit’ which developed a plan of action and recommendations based on the CQC findings.  

Healthwatch Wiltshire (the independent consumer champion for health and social care), while disappointed at the findings, said they had been “assured that since the inspection the Trust [AWP] has acted quickly to make safe some of the unsafe environments where patients are being cared for.”

Dr Lelliot recognised that AWP has had a change in its top leadership team “…which has now embarked on a programme of service improvement.”

After a terrible report on AWP in July 2012 by the then Strategic Health Authority which called AWP “centralist, top down, target driven, bureaucratic and controlling”, a new chief executive was brought in and the organisation was reorganised around  locality teams.  

In June 2013 independent inspectors praised the progress AWP was making to get back on track.

Marlborough News Online has yet to find in the report significant analysis of the increase in demand over recent months for mental health services across AWP’s large geographical area.  It is public knowledge that there has been increased demand on mental health services across the NHS in England.

Two days ago, the ‘We Need to Talk Coalition’ (a group of charities and clinicians) said that mental health services were unable to cope with the demand for psychological therapies.  

The ‘Coalition’s’ report found that referral rates and waiting times vary hugely, one in ten wait over a year just to be assessed, one in six people attempt suicide while waiting for psychological treatment, and that the number of patients paying to go private has shot up from one in ten to one in four in a year.