The following summary is taken verbatim from the Healthwatch Enfield website
Barnet, Enfield and Haringey Mental Health NHS Trust rated "requires improvement", following inspection
30/03/2016
England's Chief Inspector of Hospitals has rated Barnet, Enfield and Haringey Mental Health NHS Trust as Requires Improvement following an inspection by the Care Quality Commission (CQC).
CQC inspectors found that although the trust leadership team had identified many of the problems facing the organisation and made a start to address them, there was still much to do.
Inspectors rated five of the 11 core services as good and the forensic services as Outstanding. Five services were rated Requires Improvement: the acute mental health admission wards for adults, the community based mental health services (mainly the community recovery teams), the child and adolescent mental health ward the Beacon Centre, the specialist community mental health services for children and young people, and crisis mental health services which include the home treatment teams.
The main areas for improvement were as follows:
- The trust had a substantial problem with staff recruitment and there was a high use of temporary staff that was affecting the consistency of care. There were too few regular staff to consistently guarantee safety and quality in the acute mental health wards, the child and adolescent ward and in the Enfield health visiting services. There were staffing problems in some other areas but these were not as severe.
- A significant number of new or interim managers provided important support roles or directly led teams providing care. Permanent managers with strong leadership skills were needed to improve and sustain standards of care.
- The management of risk was variable across the mental health services. In some cases this was because staff had not considered individual risk or updated records following specific incidents. Sometimes the record keeping needed to improve. This meant that there was a possibility of staff not safely supporting patients with their individual risks.
- The trust did not operate lone working arrangements robustly in some of the community mental health services. Staff safety was potentially compromised.
- Patients had absconded from mental health inpatient wards while detained under the Mental Health Act. These incidents and the learning from them were not being addressed.
- Staff in acute mental health inpatient wards did not always recognise when a patient’s physical health was deteriorating and ensure they received timely input.
- The trust’s communication with primary care needed to improve, both when patients were being discharged from inpatient services, and throughout their ongoing care and treatment.
- The telephones and IT systems did not support effective working by staff in the community. Whilst the trust was working on this there was more to be done.
Inspectors found that despite the problems there was much for the trust to be proud of. The senior executive team were committed to improving services and to providing a high standard of care for patients receiving treatment from the trust. Staff working for the trust valued the leadership provided by the senior team, especially the chief executive.
The main areas which were positive were as follows:
- Most of the staff inspectors met were caring, professional and worked tirelessly to support the patients using the services provided by the trust.
- The trust was continuously looking at how the patients using their services could be supported with their ‘enablement’ and there were new projects with other external providers.
- The trust had improved the arrangements for patients to access the Enfield community health services.
- The trust was working to reduce the use of physical interventions. The use of restraint was low and on the forensic wards they made good use of relational security to minimise the use of restraint and seclusion.
- Staff had access to a wide range of opportunities for learning and development, which was helping many staff to make progress with their career whilst also improving the care they delivered to people using the services.
- Staff morale was good and most staff said how much they enjoyed working for the trust.
- Staff felt able to raise concerns and most had done so where needed.
- The trust had a robust governance process that identified areas of concern and monitored progress in addressing these matters. The trust had recently introduced a new management structure for services based on borough lines and this was well received.
The CQC will be working with the trust to agree an action plan to improve the standards of care and treatment.
Full reports of the inspection including ratings for all core services are available at this link.
