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CQC report unveils improvements needed for Mental Health Inpatient Units at Cumbria Partnership NHS Foundation Trust

Mental health units in Cumbria 'require improvement' Photo: ITV Border

Mental health units in Cumbria have been rated as 'requires improvement' by inspectors.

The Care Quality Commission (CQC) has published the findings of its comprehensive inspection programme of all specialist mental health services in England.

Following the inspection, the rating of Mental Health inpatient units at Cumbria Partnership NHS Foundation Trust have remained as ‘Requires Improvement’, with two areas being rated as ‘Good’.

In February 2017 the CQC carried out an unannounced inspection of Mental Health Inpatient Units and Psychiatric Inpatient Care Units across the county.

The CQC assessed the following five areas, which were each given a separate ratings:

  • Are services safe? Requires improvement
  • Are services effective? Requires improvement
  • Are services caring? Good
  • Are services responsive? Good
  • Are services well-led? Requires improvement

We have told Cumbria Partnership NHS Foundation Trust that they must make improvements in the acute wards for adults of working age and psychiatric intensive care units.

“We found a number of concerns about both the safety and effectiveness of services, and how well-led they are.

“We found there were not always enough doctors covering during evenings or at weekends on some of the wards and units. Inspectors were unable to find records of consent to treatment for detained patients, and it was unclear if clinicians were completing capacity assessments during consultations.

“Overall the trust remains rated as Requires Improvement. We will continue to monitor these services closely and work with partners to ensure the safety of people using them. We will return in due course to check on progress."

– Dr Paul Lelliott, The Deputy Chief Inspector of Hospitals (and lead for mental health)
West Cumberland Infirmary Credit: ITV Border

Cumbria Partnership NHS Foundation Trust says they are thankful to staff for their commitment in continually improving their services.

Despite the CQC rating remaining the same, we are incredibly proud of our staff who work within the mental health inpatient wards.

We know we still have more work to do to improve the areas highlighted in the report and will be continuing with the work already in place to address these issues and have already begun creating action plans to address other areas of improvement."

– Clare Parker, Director of Quality & Nursing at Cumbria Partnership NHS Foundation Trust
Cumberland Infirmary Credit: ITV Border

The report includes a series of actions that the Trust must take, which includes:

  • Ensuring that the medicine management is adequate across all wards.
  • Ensuring that patients have access to psychological therapies on all wards.
  • Improving the incident reporting system.
  • Addressing the out of hour’s medical cover available across the wards.
  • Ensuring records of consent to treatment for detained patients are undertaken.

"Whilst we are aware we need to take action to improve out of hours’ medical cover there is no evidence to suggest this has adversely impacted on patient care. The way we provide medical cover across a large geographical area is not in the conventional way that the CQC is used to seeing and as there is no nationally agreed standard to work to. We have already undertaken an extensive review of all of the options available to us and we have a quality summit later this month with the CQC and our commissioners to discuss how we address this.

“Due to recruitment issues and staff shortages, we have been unable to fully utilise psychological therapies. Our nurses have however been providing psychologically informed interventions via one to one sessions and we will be undertaking a quality improvement project planned to increase the psychologically informed practice across the wards.

“We have reviewed in detail why the support in place has not translated into all staff being aware of the capacity to consent within patient care and have undertaken a focus group with consultants to improve the uptake of training and manage this though clinical audit and supervision. We are hopeful by implementing this recommendation from the CQC as priority we can address this with our staff to ensure patient assessments and treatment are as effective as possible."

– Dr Andrew Brittlebank, Medical Director at Cumbria Partnership NHS Foundation Trust