England’s Chief Inspector of Hospitals has rated the services provided by Solent NHS Trust as Requires Improvement following an inspection by the Care Quality Commission in June and July 2016.
The trust is a specialist provider of community and mental health services to people living in Southampton, Portsmouth and areas of Hampshire, and is the main provider of mental health services to people living in Portsmouth.;
Overall, the trust was rated Requires Improvement. A team of inspectors rated the trust as Requires Improvement for providing services that are safe, effective and well-led, and Good for being caring and responsive to people's needs.
During the inspection CQC looked in detail at the trust’s mental health locations and community health services. Full reports including ratings for all of the provider’s core services are available on this website.
Professor Mike Richards, Chief Inspector of Hospitals, said:
"At the time of inspection, we found many areas of good care across Solent NHS Trust services on the wards and in the community, although there were a number of areas where improvements must be made.
“Generally we found staff provided compassionate care and treated patients with dignity and respect. I am pleased that in an effort to bring care closer to people’s homes the trust has been working well with other agencies to reduce hospital admissions and also promote integrated care in the community.
“The trust can be proud of many of the services that it currently manages – particularly the areas of outstanding care in the Learning Disability unit, and the care from ancillary and non-clinical staff in the Jubilee Ward.Staff were positive about working for the trust and for how the Chief Executive promoted an open and accessible culture.
"However, we also found that staff did not always follow policies and procedures to safely manage medicines. There were some staffing vacancies which impacted on service delivery. Staff did not always assess and manage risks to patients. Patients were not always involved in making decisions about their care and treatment, and we found that patient records were sometimes incomplete.
“The leadership of the trust have told us they have listened to our inspectors’ findings and we are confident that the staff will work to deliver these improvements on behalf of their patients. We will return in due course to check on the progress that they have made.”
The reports highlight several areas of good practice, including:
- Community mental health services for people with a learning disability were outstanding.
- The trust was listed as the most research active care trust in 2015/16 in the National Institute for Health Research National League Tables.
- There were many examples across community services of integrated working, new models of care, therapy based initiatives and early intervention projects to promote public health.
- The trust had developed innovative processes for learning from mortality in community and mental health settings. The trust was developing its approach across Hampshire and Isle of Wight and was working with national organisationsto further develop the process.
- There was evidence of good and innovative practices, such as the interactive “Trache bus” - a service which was available to children living in Portsmouth. It provided valuable care to children with an established tracheostomy (an artificial opening into the windpipe (trachea) that is held open by a tube.This helps the child to breathe more easily.)
- The Tulip Clinic for sex industry workers and exploited children demonstrated good practice.
Inspectors said that the trust must improve in some areas, including:
- In community adult services there must be enough suitably qualified staff to ensure consistently safe and timely care that meet patients’ needs.
- The trust must ensure that all patient records are complete and that all staff have access to electronic patient records when required.
- The trust must work with commissioners to reduce long waiting times for wheelchairs.
- Medicines must be safely managed in community school services.
- Community-based mental health services for older people must take reasonable steps to ensure people are involved in making decisions about their care and treatment.
- Risks assessments must be completed for all children and young people in specialist community mental health services, and there must be an effective system in place to assess the risks to young people whilst they were waiting for assessment or treatment. Crisis plans are completed for all young people who are assessed as requiring them to keep them safe and staffing levels are as planned and staff have appropriately training.
- There must be appropriate monitoring of prescribing of medicines, and staffing levels are as planned to be able to manage caseloads in Southampton substance misuse services.
- Mental health patients with potential safeguarding issues must be managed safely acute ward, Hawthorn ward, and the psychiatric intensive care unit Maple ward and on wards for older people with mental health problems.
- There must be a clear segregation of male and female bedrooms on the acute wards.
- There must be appropriate governance systems to monitor mental health crisis services and the health-based places of safety.
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