The Care Quality Commission (CQC) has published a report following an inspection at Black Country Healthcare NHS Foundation Trust in November.
CQC carried out the inspection due to a transfer of mental health services, previously run by Dudley and Walsall Mental Health Partnership NHS Trust, (now Dudley Integrated Health and Care NHS Trust) to Black Country Healthcare NHS Foundation Trust.
During this inspection, CQC looked at the overall management of the trust, wards for adults of working age and psychiatric intensive care units, mental health crisis services and health-based places of safety, as well as wards for older people with mental health problems.
Due to COVID-19, CQC only looked at the areas of concern, rather than all services run by the trust.
Following this inspection, the trust’s overall rating remains as good. The ratings for effective, well-led, responsive and caring remain as good, and the rating for safe went down from good to requires improvement.
Craig Howarth, CQC’s head of hospital inspection, said:
“During our latest inspection of Black Country Healthcare NHS Foundation Trust, we found a well-managed trust that continued to provide good care.
“From the moment people arrived, they were regularly assessed, kept up to date with their care plans and had access to a range of specialists. Staff helped people live healthier lives by supporting them to take part in programmes or giving them advice. For example, the wards arranged walking groups to encourage exercise and help with wellbeing.
“Levels of restrictive interventions were low. Staff tried to avoid using restraint by using de-escalation techniques and only restrained patients when these failed and it was necessary to keep the patient or others safe. Also, when a patient was placed in seclusion, staff kept clear records and followed best practice to provide the best possible care.
“We found there was a positive and open culture across the trust and staff said they felt happy and enjoyed their work. They felt respected, supported, and valued and we heard how well the trust supported staff during COVID-19.
“While we found many areas of good practice, we also found areas where the trust needed to make improvements, particularly around the safety of the environment in some areas. We have highlighted these to the trust’s leadership team, and they are aware what they need to do to improve this.
“We will continue to monitor the trust, and our inspectors will return to check on progress. In the meantime, everyone at the trust should be proud of what they have done to consistently meet a good standard of care.”
Inspectors found:
- Staff followed procedures to minimise risks where they could not easily observe patients.
- Staff completed and regularly updated environmental risk assessments of all wards areas and removed or reduced risks they identified.
- There had been good engagement with external stakeholders. The trust had key roles in the development of the local health and social care system working and collaborated with care providers to improve mental health services.
- The trust board was diverse. Non-executive directors represented different communities and the executive directors presented an effective mix of members from diverse backgrounds with a wide range of skills and experience.
- There were clear responsibilities, roles and systems of accountability to support good governance and management.
- Services treated concerns and complaints seriously, investigated them and learned lessons from the results.
However:
- There were not always enough alarms in the wards for older people meaning staff could not get help quickly if there was an emergency.
- The seclusion room at the Macarthur Centre psychiatric intensive care unit was poorly furnished and the toilet and washing facilities needed updating.
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