Adults health at risk following a poor care home inspection 

The Care Quality Commission (CQC) has reduced its rating for Essex Partnership University NHS Foundation Trust from ‘good’ to ‘requires improvement’ following recent inspections.

The trust provides support, treatment and advice to people experiencing poor mental health, including people detained under the Mental Health Act.

The inspections were carried out in response to concerns CQC received about the safety and quality of services. The CQC also followed up a warning notice it issued to the trust in October last year following an inspection of its acute wards for working age adults and psychiatric intensive care units (PICU).

As well as the overall rating declining, the trust’s ratings for effective, responsive and leadership have also dropped from good to requires improvement. The trust’s rating for safe has been again rated requires improvement. Its rating for caring dropped from outstanding to good.

The individual service ratings have also been updated:

• Acute wards for adults of working age and PICU dropped from requires improvement to inadequate
• Wards for autistic people and people with a learning disability dropped from good to requires improvement, as did community-based mental health services for adults of working age
• Wards for older people with mental health problems were again rated requires improvement overall, as were mental health crisis services and health-based places of safety
• Substance misuse services went up from requires improvement to good overall.

Rob Assall, CQC’s director of operations in London and the east of England, said: ‘When we inspected the trust, we were very disappointed to find people’s safety being affected by many of the same issues we told the trust about at previous inspections. This is because leaders weren’t always creating a culture of learning across all levels of the organisation, meaning they didn’t ensure people’s care was continuously improving or that they were learning from events to ensure they didn’t happen again.

‘For example, one ward continued to restrict people going into the garden because of a blind spot where staff couldn’t see people to ensure their safety. We told the trust to address this in October last year, yet people were still being restricted because the blind spot was still there.

‘We found multiple incidents where staff had fallen asleep or didn’t interact with people during observations. Yet senior leaders believed observations had improved because their data wasn’t always accurate.

‘Despite these issues, leaders recognised the need to develop a learning culture and were implementing many programmes to do so. For example, the trust had given people more ways to give feedback and were using a new process to improve learning when things went wrong.

‘However, many of these improvement programmes started long after issues were identified and it shouldn’t have taken them this long to address things affecting people’s safety and well-being.

‘Immediately after the inspection we told the trust the areas where improvements are needed. We’ll continue monitoring the trust to ensure they’re providing safe care and treatment and return to check that leaders have followed through with their improvement programmes.’

Inspectors also found:

• People weren’t always cared for by staff who knew them and the service well, due to a high usage of agency staff. On acute wards, there weren’t always enough staff to keep people safe. The trust had plans to respond to staffing issues but these were new and hadn’t had time to embed
• Leaders didn’t always support staff through regular supervision to improve the care they gave to people
• Staff didn’t always follow the trust’s processes to safely store, prescribe and give people medicines. There weren’t always enough pharmacy staff to support with this
• The trust had recently created a new complaints system, but some old complaints were still unresolved
• People mostly said they felt safe, valued and respected. However, some people on acute wards said staff on night shifts were uncaring.

Image: Claudia Love