Concerns raised over children's mental health services in Weston
PUBLISHED: 00:01 26 June 2019 | UPDATED: 07:43 27 June 2019
Weston Area Health NHS Trust (WAHT) has been told it must improve after 'immediate concerns' were raised about the quality of children's mental health services.
The rating given to mental health services for children and adolescents has dropped from outstanding to inadequate, following an inspection by the Care Quality Commission (CQC)in February and March.
Inspectors found staff had not assessed ligature risks, there were no plans in place to manage risks and they did not always feel able to protect young people from avoidable harm due to high demand and staff shortages.
Dr Nigel Acheson, CQC's deputy chief inspector of hospitals, said: "While I am encouraged the trust has made progress to address our concerns from our inspection in 2015, there is still a lot more to do.
"At the time of our inspection we made it clear the risks created by the lack of staffing and the issues within the child and adolescent mental health services do need to be addressed quickly.
"The leadership team knows what it needs to do to address the challenges that face them and there are a number of competing priorities for the team.
"This means that capacity to address all the challenges adequately is a concern but still these issues do need to be addressed."
The CQC gave the trust an overall rating of 'requires improvement'.
It has been told to improve its safety, responsiveness and leadership, while it received good ratings for being caring and effective.
In urgent and medical care, patients could not always access care where they needed it and there was a lack of staff with the right qualifications.
Inspectors found significant improvements in medical care, although patients were not always receiving the right medication at the right dose and time and there was not always enough staff, and surgery services were rated as 'good'.
Mr Acheson said: "It is well known Weston Area Health has faced its challenges over recent years and I am aware staff have worked hard to overcome these.
"The ongoing uncertainty over the trust's direction continues to overshadow the day-to-day business of the hospital."
He added: "We will continue to check the trust's performance and will return to report on further improvements in due course."
Weston Area Health Trust's response to the report
The trust praised its dedicated staff after CQC inspectors recognised improvements made since the previous inspection.
The inspection found staff cared for patients with compassion, dignity and respect and involved them in decisions about their care and treatment.
Of the 44 indicators which make up the trust's overall rating, 27 are rated as 'good' and one is 'outstanding.
WAHT's overall rating for whether services are effective has improved to 'good', and the trust has retained its overall rating of 'good' for patient care.
James Rimmer, WAHT chief executive, said: "We are pleased that, thanks to our hardworking and dedicated staff, the inspectors have recognised we are on a journey of improvement and have made clear progress since their last inspection.
"However, we fully accept there are areas in which we need to improve further.
"Work to address the issues identified, particularly in relation to our Children and Adolescent Mental Health Service (CAMHS) has already been undertaken. "Robust risk assessments have been carried out and actions identified have been completed.
"As with CAMHS across the country, high levels of demand and difficulties in recruiting and retaining staff mean we cannot always see people as quickly as we would like.
"We would like to apologise to our patients and their families for any distress that this may have caused.
"We have now made progress in recruiting more staff into our service and we have already seen a reduction in our waiting list."
The CQC found that despite the challenges the trust faces, patient care is not being compromised and there is a clear focus on safety.
Peter Collins, WAHT medical director, said: "Our priority is providing safe and high-quality care to those who need our services.
"We have made significant progress in our emergency department and patient outcomes are in line with those of similar services.
"We were already taking steps to strengthen culture and governance at the time of the inspection and we continue to build on the good work we have started.
"It is testament to our staff the impact of the challenges we face is minimised for our patients.
"The CQC found our patients are treated with compassion and respect and that is reflected in maintaining an overall rating of good in relation to patient care."