Improvements needed at South West Yorkshire Partnership NHS Foundation Trust following CQC inspection
An inspection was carried out at the trust’s acute wards for adults of working age and psychiatric intensive care units and the forensic inpatient or secure wards, due to information of concern received about the safety and quality of the services.
Following the inspection, the following ratings were given at each service:
- At forensic inpatient and secure wards: The overall rating for the service has gone down from good to requires improvement. The ratings for effective, responsive and well-led have gone down from good to requires improvement, safe remains as requires improvement and caring remains as good.
- At acute wards for adults of working age and psychiatric intensive care units: The overall rating for the service remains requires improvement. Safe, well-led, effective and caring are rated requires improvement again, and responsive has gone down from good to requires improvement.
The overall rating for the trust remains as good.
Sheila Grant, CQC deputy director of operations in the North, said:
“When we inspected services at South West Yorkshire Partnership NHS Foundation Trust, we observed a deterioration in some areas in the quality of care being provided to people. The leadership team needs to focus on making the necessary improvements to ensure people receive appropriate care.
“On the forensic inpatient and secure wards, we were concerned that staffing pressures resulted in high levels of bank and agency staff on some wards which impacted the quality of care people received. Understaffing also meant people’s leave and activities were sometimes cancelled which affected their well-being.
“We also found inconsistencies in the way different wards were run at both services. Managers need to have better oversight and ensure staff are suitably supported, trained, and appraised so they can carry out their roles effectively.
“It was positive, however, to hear that senior leaders had created a culture on the wards where people using the service and staff felt supported and were able to express their views. People told us that staff were kind, compassionate and treated them well.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people can receive safe and appropriate care.”
Inspectors found the following during this inspection:
At forensic inpatient and secure wards:
- Staff did not always consider individual circumstances when applying restrictions. For example, patients did not have unsupervised access to outside space on most wards.
- Not all staff had received training on meeting the needs of patients with a learning disability or autistic people.
- Governance processes did not always ensure managers had full oversight of quality or ensure that ward procedure ran smoothly.
- Staff didn’t always follow the trust’s duty of candour policy. A letter of apology was not always sent to people as required and senior staff were not clear about this requirement.
- Staff treated people with compassion and kindness and understood the individual needs of people.
- Staff planned and managed discharge well and liaised with services that would provide aftercare.
At acute wards for adults of working age and psychiatric intensive care units:
- Staffing pressures within some specific staff groups were impacting on the experience of people and the quality of care they received.
- Physical restraint of people in the prone position (face down) was used more frequently than national guidance recommends.
- People weren’t always adequately monitored following the administration of emergency medication or while in seclusion.
- A high proportion of staff weren’t having regular performance appraisals in line with the trust’s appraisal policy.
- Staff were aware of their responsibilities in relation to safeguarding adults at risk of abuse and raised safeguarding concerns appropriately.
- Senior leaders created a culture on the wards where patients and staff felt supported and were able to express their views.
The full report will be published on CQC’s website on Wednesday 6 December.
