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Chief Inspector of Hospitals finds that Central and North West London NHS Foundation Trust requires improvement
England's Chief Inspector of Hospitals has told Central and North West London NHS Foundation Trust that it must improve the quality of some of its services following an inspection by the Care Quality Commission.
Overall the trust has been rated as requiring improvement. Although the trust provided services that were outstanding for being caring and good for being effective and well led, improvements were needed for services to be consistently safe and responsive.
Central and North West London NHS Foundation Trust provides health and social care, including mental health services, to three million people in London, Milton Keynes and Buckinghamshire. More than half of the trust’s services are provided in the community, in people’s homes, clinics and schools. The trust also has specialist inpatient services for people needing intensive treatment.
During the inspection in February a team of inspectors and specialists including doctors, nurses, managers and experts by experience visited 137 of the trust’s hospital wards and clinics, spoke to 285 patients, relatives and carers and interviewed 913 members of staff.
Full reports on all core services are available at www.cqc.org.uk/provider/RV3.
CQC found considerable variation in the quality of the services provided by Central and North West London NHS Foundation Trust. The community health services were rated as Good with the sexual health services rated as Outstanding. As a whole, the trust was rated Outstanding for caring reflecting the individualised care provided in the community dental and sexual health services. Overall, mental health services were rated as Requires Improvement.
Inspectors found the trust had worked to meet the needs of diverse communities, providing care which was sensitive to the cultural backgrounds of patients. Inspectors saw the trust working well with the statutory and voluntary sectors.
Dr Paul Lelliott, CQC’s Deputy Chief Inspector of Hospitals, said:
“Our greatest concern was the pressure on the mental health wards that admit people of working age. Our inspectors found people sleeping on sofas and in other temporary beds. Ward staff could not always find a bed for people returning from leave and some people were being asked to sleep on a ward for older people. We also found that patients were sometimes being transferred from ward to ward late at night and early in the morning.”
“The trust had not increased staffing levels to reflect the pressure on beds. Also ward staff were using physical restraint in the face-down position about 75 times each month. This is not the safest way to restrain a person”.
“We also found many examples of good services. The inspection team found many examples of where the trust had embraced innovation and change and made opportunities for research and development. Also, it is a credit to all the staff employed by the trust that we found the trust outstanding for being caring. Across the trust, care was delivered by hard-working, caring and compassionate staff.”
“I accept that other mental health trusts face great challenges with pressure on admission beds. Despite the problems we found at CNWL, we concluded that the trust had a strong leadership team who had developed an open culture where the vision and values were known and were being put into practice. At the time of the inspection the trust was implementing a new divisional structure with a greater focus on local contact which I would hope will ensure effective communication and learning”.
“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. We will return in due course to check that the improvements that we have identified have been made”.
The reports highlight several areas of outstanding practice including:
A homelessness prevention initiative in Westminster, and a street triage scheme in Milton Keynes, a joint initiative with the police to help reduce the number of people being taken to a police cell as a place of safety.
The reports which CQC will publish today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations including Healthwatch.
Yesterday (Thursday 18 June) the Care Quality Commission presented its findings to a local quality summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the quality summit is to develop a plan of action and recommendations based on the inspection team’s findings.
For further information please contact CQC Regional Engagement Manager John Scott on 07789 875809 or 0191 233 3548 or, for media enquiries, call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. (Please note: the duty press officer is unable to advise members of the public on health or social care matters).
For general enquiries, please call 03000 61 61 61.
- Last updated:
- 29 May 2017
Notes to editors
The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading inspection teams that include CQC inspectors, doctors, nurses, managers and experts by experience (people with personal experience of using or caring for someone who uses the type of services we were inspecting). By March 2016, CQC will have inspected and rated all acute NHS Trusts in England. Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?
Since 1 April, providers have been required by law to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily. This should be done within 21 days of publication of their inspection report. For further information on the display of CQC ratings, please visit: www.cqc.org.uk/content/display-ratings.