England's Chief Inspector of Hospitals has rated Greater Manchester Mental Health NHS Foundation Trust as Good following an inspection by the Care Quality Commission. This inspection included child and adolescent mental health wards and wards for older people which had previously been rated as requires improvement.
CQC also inspected acute wards for adults of working age and psychiatric intensive care units; long stay/rehabilitation mental health wards for working age adults and substance misuse services. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
The service was rated as Requires Improvement for safety, Good for caring, effectiveness and responsiveness and Outstanding for well-led. As a result of this inspection, the trust’s overall rating remains unchanged as Good.
Paul Lelliott, Deputy Chief Inspector for hospitals and lead for mental health:
“Greater Manchester Mental Health NHS Foundation Trust was formed a year ago when two NHS trusts combined. It was clear to our inspectors that the leadership team had successfully overseen the acquisition of a number of poorly performing services and were managing to maintain a strong performance."
“We found that the relationships with stakeholders for Manchester services, including staff, unions, commissioners had improved. There was a strong commitment to provide the best care for all patients across the service."
“However - there are areas for improvement. We have made it clear that the trust needs to focus further on safety. In acute wards for working age adults and psychiatric intensive care units, staff were not following the trust’s policy in relation to rapid tranquilisation and in child and adolescent mental health wards, checks to ensure that equipment was safe to use had not always been carried out."
“Inspectors said staff dealt with patients with commitment, energy and patience. Staff were proud to work for the organisation. Leaders were visible and approachable and understood the challenges facing the trust."
“The inspectors found that although there were vacancies and sickness, the trust’s systems to manage this ensured there were sufficient staff. Some training courses were below the trust target, but the trust had taken steps to ensure there were enough skilled staff to provide care. Medicines were managed safely. Risks related to the two electronic management systems were being managed.”
Care plans were not always personalised in acute wards for working age adults and psychiatric intensive care units, but otherwise care plans were holisitic and patient centred. While the rights of people who were detained were protected, there were issues with forms of authorisation and requests for second opinion doctors in wards for older people.
Feedback from people using the service was positive, with patients and carers reporting that staff were supportive and kind. People were generally involved in planning their care although this was not always the case in acute wards for adults of working age and psychiatric intensive care units. Substance misuse services received the highest proportion of compliments from patients.
The inspection team found some outstanding areas of practice. In substance misuse services the rapid access to the alcohol pathway provided by the Chapman Barker Unit was an innovative and effective service. The service accepted referrals from accident and emergency services within Bolton and Trafford and provided rapid access to specialist detoxification as an alternative to hospital admission.
The trust had established a building recovery in communities asset fund. This was used to support a range of recovery orientated groups and projects including allotments, training cafes, theatre groups and gym access.
CQC will return to inspect the trust at a later date to check on whether further progress has been made.
Full details of the ratings, including a ratings grid, are given in the report published on our website.
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