- NHS mental health service
Trust Headquarters
All Inspections
5 July 2018
During an inspection looking at part of the service
This inspection was an announced focused inspection carried out on 5 July 2018 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection between 10 and 13 July 2017.
The July 2017 comprehensive inspection was carried out in partnership with Her Majesty’s Inspectorate of Prisons (HMIP) under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions in accordance with our published methodology. CQC issued one Requirement Notice under Regulation 9 of the Health and Social Care Act (Regulated Activities) Regulations 2014 to Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV). This can be found in Appendix 2 of the joint inspection report. The joint inspection report can be found at:
https://www.justiceinspectorates.gov.uk/hmiprisons/wp.../Holme-House-Web-2017.pdf
This focused inspection report covers our findings in relation to those aspects detailed in the Requirement Notice dated 5 December 2017 and findings published in the joint report. We do not currently rate services provided in prisons.
Our key findings at this focused inspection were as follows:
• The trust had taken positive action to improve the delivery of mental health services.
• All referrals made to the mental health team were triaged on receipt and allocated to a mental health practitioner within 24 hours. Assessments now took place within a week.
• Care plans were now well developed and showed evidence of patients’ involvement in their planned care.
• Clear timescales for continuation of patient care were recorded in care plans; all had been reviewed to ensure follow up assessments; and future appointments were documented.
• Caseload management had improved significantly and was monitored and discussed by staff and managers at both individual and team meetings.
• Managers had made improvements to recording systems and patient information templates to ensure a consistent approach.
18 September 2013
During an inspection looking at part of the service
16, 17, 18, 19, 24 July 2013
During a routine inspection
Some of the people we spoke with reported a good level of support and care. For example one person told us, 'The difference it's made to my well-being is exceptional." A carer told us, 'Advance statements work really well. My stepson and his father wrote one together and this is on his file'. However, some carers reported to us they felt excluded from decisions about care and support for themselves as carers.
We found overall people experienced care, treatment and support that met their needs and protected their rights.
We found the teams we visited worked in cooperation with a number of different partners to protect and promote the health, welfare and safety of people who used the service.
27, 28 August and 5 September 2013
During a themed inspection looking at Offender Healthcare
In the survey 48% of prisoners who told us they had mental health needs rated the quality of mental health services as good, which is better than in other similar prisons. The men told us that they were happy with the healthcare being provided by Tees, Esk and Wear Valleys NHS Foundation Trust. They said, 'The nurses really take time to listen to you'. We found that the men were able to readily access mental health services, as the staffing levels were sufficient to meet the demands of the service at HMP Holme House.
We found that Trust services operated to a very good standard. There was a good system in place for utilising the expertise of all the practitioners in the community forensic team and this meant prisoners could have access to DBT, specialist consultants and other therapists such as OT when needed. We found that the staff team worked well with both the prison staff and other clinicians when delivering care to the men. The mental health team provided both primary and secondary mental health services and we found that they worked well with both the prison staff and other clinicians.
20, 29 November and 10 December 2012
During an inspection in response to concerns
The four people we spoke with confirmed that they had received information about the treatment, and how it would be monitored, at the initial appointment to help them decide if that was what they wanted.
However, we found that where complex medicines were prescribed there was no standard operating procedure to make sure that these medicines were always managed in a consistent and safe way. In one clinic, remote from the main trust locations, we saw that unsafe practices were used when repeat prescriptions for medicines were supplied. This meant that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to safely manage them.