HOSPITAL ORDERED TO IMPROVE ITS SERVICES IN MENTAL HEALTH
Trust says issue is ‘documentation not care’
A HOSPITAL has been issued with a warning notice and told there needs to be ‘significant improvement’ to mental health services.
Inspectors found that effective systems were not in place ‘to assess, record and mitigate the risks associated with acute mental health concerns’ at County Hospital in Stafford.
The Care Quality Commission visisted University Hospitals of North Midlands, which runs the County Hospital, to assess progress made in relation to two improvement notices issued in 2019 relating to urgent care and mental health.
While the trust received positive feedback on urgent care, inspectors found various issues in mental health at County Hospital, resulting in the ‘section 29’ notice.
But hospital managers insist the problems related to documentation, and that patients did receive the appropriate care.
The CQC concerns include:
Mental health risk assessments were not consistently reviewed or revisited on admission to wards;
Deprivation of Liberty Safeguards were not in place for patients who most likely lacked capacity but were under restrictions;
One patient was not provided with an interpreter to assess his capacity to consent;
Two patients were being restricted unlawfully, as legally required procedures were not being followed.
UHNM has been told it needs to make the necessary improvements by January 26.
Chief nurse Ann-marie Riley told a
UHNM board meeting the trust had put in place the appropriate systems and processes to address the issues previously raised by the CQC.
But she said staffing pressures meant documentation was not always completed on time.
She said: “What I do want to make clear is the CQC did acknowledge the work that we had done, in terms of putting in robust systems and processes, and they were acknowledged to be appropriate.
“With the cases that were mentioned in the letter, the CQC acknowledged that staff were working in line with the patients’ best interests, that the assessment intervention was appropriate – the delay was in the documentation of the interventions.
“We have to acknowledge the pressure that staff are under, and the impact that will have on documentation.”
The board was given an update on the progress made in relation to all the issues with urgent care and mental health previously raised by the CQC, with most of the required actions either completed or on track.
But board members raised concerns the warning notice seemed to suggest the trust’s own internal assessment of its progress was flawed.
Audit committee chair Gary Crowe said: “The nature of assurance we’re relying on here, has not been effective in this case. There’s assurance here that we’ve relied on, which is pretty much a self-certification that we have taken the necessary action – but there’s a gap, as highlighted by the external review, in the practice of the organisation.”
Chief executive Tracy Bullock said: “Sometimes when you’ve only got one or two qualified nurses on a ward, the first thing to go is documentation. We did highlight that as a risk, and have done throughout the whole of covid, that the staffing pressures we’re working with will mean staff will focus on giving patients appropriate care.
“But we couldn’t generate more staff because the staff aren’t there.”