Threat of special measures for ‘inadequate’ East Anglian healthcare trust

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An under-fire mental health trust is being threatened with special measures after healthcare watchdogs found serious failings in patient safety and staff morale.

The Norfolk and Suffolk NHS Foundation Trust was rated ‘inadequate’ by the Care Quality Commission following inspections in October.

The Chief Inspector of Hospitals has recommended the trust, which also provides services for those with learning disabilities and eating disorders, be placed into special measures.

In the CQC report, published on Tuesday, inspectors found the trust to be ‘in breach of regulations’ with ‘urgent action’ required by its board to ‘address areas of inadequecy’.

Inspectors reported the board could not assure them it knew how the trust was performing, and how decisions were implemented or impacted on quality.

Despite the trust labelling staff engagement as a ‘key priority’, inspectors said they were ‘unable to find evidence of action’ around it.

Staff morale was found to be ‘very poor’, with some telling inspectors they had ‘no confidence in senior staff and felt they had been let down’.

The CQC’s Deputy Inspector of Hospitals, Dr Paul Lelliott, said: “We found a number of serious problems when we inspected the services run by Norfolk and Suffolk NHS Foundation Trust.

“We were concerned about the safety and quality of care provided by some of the trust’s services. We were also struck by the low morale of many of the staff that we interviewed who told us that their voices were not heard by those managing the trust.

“Some of the top team at Norfolk and Suffolk NHS Foundation Trust are quite new in post. They must provide the leadership to bring about the urgent improvements were needed to ensure that care and treatment consistently meets the required standard.”

Dr Lelliott said the trust’s managers had listened to inspectors’ findings and thad begun to take action where it was required.

He added the CQC had maintained close contact with the trust since October and would undertake further inspections to ensure improvements were being made.

In their report inspectors raised concerns about environmental safety at the trust’s facilities, with some ‘unsafe’ storage of medication noted and some older patients’ wards found to be ‘cramped and cluttered’.

The trust’s systems of raising concerns were also criticised by staff and inspectors, who found a number of reported incidents ‘had not resulted in learning or action’.

A shortage of beds was consistently reported to inspectors, which caused ‘impaired patient safety and treatment’, and the environment on some wards was noted to have an impact on people’s safety, dignity and treatment.

However, inspectors did rate the trust’s quality of care as ‘good’, reporting that staff wanted to provide high levels of care ‘despite the challenges to staffing levels and some poor ward evironments’.

Positive examples of staff providing emotional supporto patients and ‘person centred’ care plans were also observed.

The trust’s chief executive, Michael Scott, hailed the report as a ‘turning point’.

“Our priority is to make sure we work with staff to improve the services we provide across Norfolk and Suffolk,” he said.

“We are under new management, the new team is bedding in, and there is no complacency on our part about the need to continue to deliver improvements.

“We know our priorities, we understand where we got it wrong and we are putting it right. We know that being truly visible leaders who are ready to listen and respond, as well as lead, has to be our approach moving forward.

“I would like to assure our patients, staff and our partners that this is a turning point for the Trust and we will continue to do everything possible to address all of the recommendations the CQC has made.”

Healthwatch Norfolk and Healthwatch Suffolk admitted concerns about the CQC’s findings, but also considered it a turning point.

Chief executive of Healthwatch Suffolk, Annie Topping, said the report confirmed Healthwatch’s understanding of ‘varied mental health services’ across the two counties.

“It is clear the Trust must make improvements to move forward and it is essential that this includes working with service users to build trust and demonstrate that they are being heard,” she said.

“We will continue to support the Trust in its journey to improve the services to ensure that this is made a reality.”