Humber mental health trust judged 'inadequate' for safety | nursing times

A mental health trust, which was told it failed to learn lessons from its last inspection, has now been rated “inadequate” for safety by the Care Quality Commission. Some clinical teams had

high vacancy rates and a number of teams were operating below the staffing levels that the trust had determined as being necessary, said the CQC today in its report on the trust. > “The 

trust must focus on the many areas for improvement” >  > Paul Lelliott Staffing was a particular problem in mental health crisis services, the health-based places of safety, the five

district nursing teams and seven community health services neighbourhood care teams, noted the regulator. It also said the trust was failing to provide sufficient training opportunities, in

that it did not ensure that its staff undertook basic training or received support for personal development. Staff compliance with training, that the trust had deemed mandatory, was only 61%

 – well below the trust’s target of 75%. Meanwhile, 50% of staff had not received recent training in the Mental Capacity Act. Overall, Humber NHS Foundation Trust was given an overall rating

of “requires improvement” by the CQC, following its latest inspection by the regulator in April. Inspectors also rated the trust as “requires improvement” in the effective, responsive and

well led domains and “good” for caring. They found a number of safety issues with the trust’s mental health services, and called its forensic and inpatient secure services as “inadequate”.

Issues highlighted in the report included: * using restrictive practices in ways that did not comply with the Mental Health Act; * proper safeguards were not in place when patients were put

in seclusion or long term segregation; * seclusion rooms and places of safety did not meet best practice guidelines; * the rapid tranquilisation policy was out of date and staff did not

always record its use, carry out the procedure safely or make the appropriate physical health checks; * staff restrained patients in a face-down position but did not always report it; and *

forensic services staff supervised all patients when they opened their mail, two years after being told that this was inappropriate. The trust was issued with a warning notice after the

inspection in April and told to take “significant steps” to improve the quality of its services. The three areas of concern in the notice were “inappropriate” rapid tranquilisation;

seclusion and segregation not being in line with legislation; and staff supervising patients opening their mail. The CQC set out actions for the trust to take in the notice, including: *

ensuring the withholding of patients’ mail is stopped; * training all qualified staff in immediate life support; * training all staff in the use of seclusion; and * urgently reviewing

geographical discrepancies substance misuse care pathways. CQC deputy chief inspector of hospitals Paul Lelliott said Humber had not learned lessons from its previous inspection in 2014 and

that the warning notice represented “very poor practice”. He added: “The serving of the warning notice was necessary to ensure that the trust addressed poor practice in respect of seclusion

and long term segregation, rapid tranquilisation and the inappropriate supervision of patients while opening mail. Dr Paul Lelliott Paul Lelliott “The trust must focus on the many areas for

improvement,” he said. ”We have received their action plan, which will form the basis and plan for our next follow-up inspection when I hope to be able to report improvement.” In a

statement, the trust acknowledged the need for improvement, but stressed 10 of its 18 services had been rated as “good”. It added: “We have welcomed the inspection process and the CQC’s

findings and we are pleased that there are many areas of good practice highlighted and recognition of our caring, compassionate and committed staff that treat patients with kindness and

respect. “We echo Dr Lelliott’s statement that we are disappointed with our inadequate rating for safety. We would like to reassure people that this rating is in a small number of services

and we have taken immediate action to address the issues.”