Essex Partnership University NHS Foundation Trust

Updated 27 August 2026

Essex Partnership University NHS Foundation Trust (EPUT) was formed on 1 April 2017 following the merger of North Essex Partnership University NHS Foundation Trust (NEP) and South Essex Partnership University NHS Foundation Trust (SEPT).

EPUT provides community health, mental health and learning disability services to support more than 3.2 million people living across Luton and Bedfordshire, Essex and Suffolk. The trust employs over 5000 permanent staff who work across 200 different sites, including providing care in people’s homes.

The trust headquarters are based in Wickford, Essex.

There are 42 integrated care systems (ICSs) in England, EPUT provides services in 4 – Mid and South Essex Health and Care Partnership, Hertfordshire and West Essex, Suffolk and North East Essex and Bedfordshire, Luton and Milton Keynes.

NHS England launched a new interactive dashboard to provide a view on how NHS trusts are performing in key areas. This means people can see how their local trust compares with other across England, each trust is placed into a segment depending on their performance in their services and other areas like financial performance. Segment 1 means an organisation is performing well and has fewer challenges, with Segment 4 being trusts with the most challenging circumstances. As of quarter 2 (July – September 2025) EPUT was placed in Segment 3.

EPUT are 1 of 3 lead providers that host the commissioning contract with NHS England for the East of England Provider Collaborative. The Collaborative had established new ways of working together to create services and support patients.

In 2025/26 the trust had a planned turnover of £649.8m and a savings requirement of £31.3m (5%). In month 12 of the financial year the trust was forecasting full achievement of its financial plan agreed with NHS England.

We undertook a trust level (well-led) assessment which included an onsite visit from 24 to 26 March 2026. We also held 12 staff focus groups on and off site and observed a board meeting in January 2026.We assessed all the quality statements in the well-led key question in this assessment.

The well-led review followed assessments of 3 of the trusts frontline assessment service groups (ASGs): long stay or rehabilitation mental health wards for working age adults, child and adolescent mental health wards and community health inpatient services. We also visited 1 acute ward for adults of working age and although this report was unrated some findings are relevant to our well led assessment. These assessments were completed due to the length of time since our last visit and rating. Ardleigh ward (acute ward for adults of working age) was visited due to concerns raised to CQC about the quality and safety of the service.

At the time of our assessment EPUT and the two previous trusts which combined in 2017 were subject to an independent statutory inquiry, The Lampard Inquiry was investigating the deaths of mental health inpatients in Essex between 2000 and 2023. The inquiry was engaged in its 'collecting evidence' stage and the trust were engaging with its requests.

The assessments identified concerns about staffing, risk management, safety and governance and oversight.

At this well led assessment there was a breach of regulation 12 (Safe care and treatment) and 17 (Good governance)

We identified areas for improvement across 6 well-led quality statements. These areas were as follows:

• Further work was needed to improve the culture of the trust with staff reporting differing experiences across teams and care groups and at times a disconnect between senior leaders and front-line services. Some staff said they were worried about speaking up for fear of reprisal. Others said that some managers did not tackle behaviours that failed to represent the values of the organisation.
• Whilst work was underway to improve the leadership development programme and support managers to promote a positive culture, this had not yet been implemented.
• The trust had put arrangements in place to cover for the impending departure of the chief executive. These will need to be kept under review to ensure they are robust and effective.
• There was not a clearly defined strategic approach to equality, diversity and inclusion (EDI) and there hadn’t always been clear leadership in this area. Improvement work is required to improve the experience of people with a disability and people from all ethnic groups equally. The patient and carer race equality framework (PCREF) was at an early stage and the lead role for was yet to be embedded following recruitment.
• Oversight of the care being delivered on the frontline and the assurance received by board needs improving. In two of our assessment service group assessments completed prior to the well led assessment we considered the use of our urgent enforcement powers due to the concerns we found. Restraints were increasing, particularly in children’s inpatient services and in inpatient services for people with a learning disability and/or autism.
• Learning in the organisation happened but was isolated and not always shared. Incident reviews were not consistent, backlogs existed that the board were not sighted on. There were missed opportunities for learning as information on delays does not make its way to board. There were repeated themes and trends in incident reviews that need to be addressed to reduce likelihood of reoccurrence.

However, we also recognised some good practice across the organisation and there were also positive findings across all quality statements. These were:

• The board was collegiate, well formed and able to function cohesively with respectful challenge.
• Effort had been made to ensure the trust was a valued system partner.
• There were good financial management arrangements and ambitions for the next financial year.
• There were ambitious and innovative plans in place for the future, particularly around understanding the culture and implementing a first of its kind system wide electronic patient record.

Updated 8 January 2026

The assessment of child and adolescent mental health wards took place on 24 February, 5 March and 26 March 2026. Essex Partnership University Trust provides 3 child and adolescent wards: .

Poplar unit is a 12 bedded mixed sex, general psychiatric ward, providing inpatient assessment and treatment for young people aged 13 to 18 years old. At the time of inspection there were 8 young people admitted to the ward.

Larkwood ward is a 10 bedded mix sex psychiatric intensive care unit, providing intensive care and treatment for young people aged 13 to 18 years old, who are experiencing acute, complex and/or severe mental health problems. At the time of inspection there were 9 young people admitted to the ward.

Longview ward is a 15 bedded mix sex, general psychiatric ward, providing inpatient assessment and treatment for young people aged 13 to 18 years old. At the time of inspection there were 9 young people admitted to the ward.

We rated the service good. The service had made improvements and was no longer in breach of Regulation 12 HSCA (RA) Regulations 2014 safe care and treatment, staff followed infection control policies with regards to wearing personal protective equipment, all medication and sharps were disposed of as per trust policy and clinic rooms did not contain out of date items, staff followed trust policies and procedures with regards to use of mobile phones in the ward areas. Regulation 18 HSCA (RA) Regulations 2014 staffing, bank and agency staff had a full induction and understood the service before starting their shift. Regulation 14 HSCA (RA) Regulations 2014 meeting nutritional and hydration needs, young people were not reliant on staff for access to snacks at prescribed times.

Mental Health Act and Mental Capacity Act Compliance Summary

The service admitted young people under the Mental Health Act 1983. Staff received and kept up to date with training on the Mental Health Act and the Mental Health Act Code of Practice and could describe the Code of Practice guiding principles. Training on the Mental Health Act was mandatory for staff; the compliance rate was 100% for Larkwood and Poplar Unit and 94% for Longview.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff received assistance from designated Mental Health Act staff.

The service had clear, accessible, relevant and up-to-date policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice. For example, there was a process in place to monitor young people’s legal status and renewal dates, which meant staff were able to ensure reviews took place in a timely manner.

Staff explained to each young person their rights under the Mental Health Act in a way that they could understand, repeated as necessary and recorded it clearly in the young person’s record each time.

Staff made sure young people could take section 17 leave (permission to leave the ward or hospital) when this was agreed with the responsible clinician. The use of leave from the ward was agreed by the multidisciplinary team (MDT). Arrangements for leave were made at daily planning meetings and nurses carried out an assessment of each young person’s mental state before each occasion of leave was utilised.

Staff stored copies of young people’s detention papers and associated records correctly and staff could access them when needed.

Mental Capacity Act

Staff received and kept up to date with training in the Mental Capacity Act. Staff had a good understanding of the Mental Capacity Act. The training was initially provided as part of the induction process and staff had regular refreshers.

Staff assessed and recorded capacity to consent clearly each time a young person needed to make an important decision. Staff took all practical steps to enable young people to make their own decisions. Staff completed an assessment on admission of each young person’s capacity to consent to admission and treatment. Further assessments took place during reviews by the multidisciplinary team.

Staff knew where to get advice regarding the Mental Capacity Act, including deprivation of liberty safeguards.

Updated 9 April 2026

Ardleigh Ward, located at The Lakes, Colchester Hospital, is provided by Essex Partnership University NHS Foundation Trust. The ward is an 18-bed acute inpatient service for female patients.

The hospital is registered with the Care Quality Commission to carry out the following regulated activities:

• Treatment of disease, disorder or injury

• Assessment or medical treatment for persons detained under the Mental Health Act 1983

The Care Quality Commission last inspected this location in July 2025 where the service was rated as Requires Improvement. We found 1 breach of the legal regulation 12, safe care and treatment, Health and Social Care Act regulations (2008).

We inspected the service in January 2026, the report for this inspection will be unrated and the ratings reflect the previous inspection only.

Our View of the Service

We carried out an inspection on the 21st of January 2026 due to receiving information of concern about safe staffing and high levels of self-harm on the ward. At this time there were 18 patients admitted to the ward.

At this inspection we found 3 breaches in relation to Regulation 12: safe care and treatment, Regulation 18: staffing and Regulation 20: good governance. Due to the serious concerns we found, we wrote to the trust and requested immediate actions. The trust were able to show how they had mitigated immediate risk to patients.

Staff did not respond appropriately to ligature alarms, and staff raised concerns at lack of support due to low staffing numbers.

One patient did not have a comprehensive risk assessment or appropriate planning for physical health care recorded.

Staff observed patients for more than the recommended time of 2 hours. This does not comply with best practice guidance.

Staff did not ensure the environment on the ward was safe for patients. High risk items that patients could harm themselves with, for example a bottle lid and a towel were discarded in a communal area. One patient’s bedroom was extremely unkempt and included high risk items such as plastic bags and empty bottles.

Staff raised concerns at the lack of time allocated to them to complete administrative tasks, this included the recording of incidents and performing comprehensive handovers.

Staffing met establishment numbers; however, this was not meeting the needs of the ward. Staff told us staffing numbers did not always make them feel assured they could provide safe care to patients with the current establishment. Patients told us that they felt they did not get the care they needed unless they were on enhanced observations.

Bank staff were not always willing to work on the ward due to the high acuity and complex needs of the patients, and the perceived risks should something go wrong. This led to further staff shortages.

Staff told us they felt burnt out and the ward felt unsafe.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

The service admitted patients under the Mental Health Act 1983.

Staff received and kept up to date with training on the Mental Health Act. Training was mandatory for staff, and the compliance rate for registered staff was 86% and 92% for unregistered staff.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff could receive assistance from the Mental Health Act team at the trust, and the mental health act office provided training for all staff.

The service had clear, relevant and up-to-date policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice.

Staff did not always record regular explanations of patients’ rights, under the Mental Health Act. We looked at 6 care records and in 1 there was no record of the patient having their rights explained. In another there was 1 recent record, but nothing in the previous 6 months. Two care records showed patients’ rights being regularly explained and 2 informal patients were having their rights explained to them regularly.

We were not provided with requested data regarding Section 17 (S17) leave and any occasions when the prescribed leave had not taken place. S17 leave (Mental Health Act 1983) allows patients detained in a hospital for mental health treatment to take authorised temporary leave from the ward.

Mental Capacity Act

Staff received and kept up to date with training in the Mental Capacity Act and had a good understanding of the 5 principles. Training on the Mental Capacity Act was incorporated into the safeguarding adults and children training and was mandatory for staff. At the time of inspection, the compliance rate was 92% for level 2 and 93% for level 3.

Staff did not complete an assessment of each patients’ capacity to consent to admission and treatment on admission. We looked at 7 care plans and 1 showed a record of an assessment taking place. There was no record of capacity assessments in the other 6 care plans we looked at.

Updated 18 September 2025

We assessed Community Health Inpatient Services, provided by Essex Partnership University NHS Foundation Trust at Saffron Walden Community Hospital and Rochford Hospital from 2 to 3 December 2025.

We visited Saffron Walden and Rochford Community Hospital as part of this assessment. We did not visit St Margaret's Hospital, but we reviewed data and spoke to carers from all hospitals. There were 3 wards in St Margaret's Beech, Plane and Poplar.

Saffron Walden Community Hospital had 1 ward. Avocet Ward was a 21 bedded rehabilitation service for patients.

Rochford Hospital had 1 ward. Cumberlege Intermediate Care Centre (CICC) was a 22 bedded ward and provided inpatient rehabilitation for patients requiring rehabilitation after a period of illness, mobility, stroke, or a fall. The hospital told us their long-term aim was for the ward to rehabilitate patients following a stroke.

The service was last inspected in May 2018. The service was rated good overall.

At this assessment we identified breaches of regulation 12 Safe Care and Treatment. We identified 3 breaches.

• The service did not always make sure that medicines and treatments were safe, available, and met people’s needs, capacities, and preferences.
• The service did not always detect and control potential risks in the care environment and make sure that the equipment, facilities, and technology support the delivery of safe care.
• Staff had not all received the mandatory training for their roles.

We rated the service as overall good in the community health inpatient service for adults.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Staff had a good understanding of the Mental Capacity Act, particularly the 5 statutory principles.We observed a multidisciplinary meeting and saw staff discussing a patient whose mental capacity was being assessed.

At the time of the assessment in the last 12 months there were 38 Deprivations of Liberty Safeguard (DoLS) applications made, to protect people without capacity to make decisions about their own care.

The provider had a policy on the Mental Capacity Act, including DoLS. Staff were aware of the policy and had access to it.

Staff knew where to get advice from within the provider regarding the Mental Capacity Act, including Dols.

Staff took all practical steps to enable patients to make their own decisions.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis regarding significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture, and history.

The service had arrangements to monitor adherence to the Mental Capacity Act.

Updated 20 October 2025

439 Ipswich Road is an 11- bedded long stay or rehabilitation ward for male and female patients, provided by Essex Partnership University NHS Foundation trust. 439 Ipswich Road provides the following regulated activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder or injury.

We completed an unannounced inspection of the service on 21 November 2025. At the time of our inspection the ward was at full capacity.

The main house at 439 Ipswich Road consisted of 8 bedrooms, 2 with en-suite facilities and 6 with shared bathroom facilities. One bedroom was located on the ground floor and 7 were located on the first floor. The Coach House was an out-building with a communal kitchen and lounge. There was 1 ground floor bedroom with an en-suite, a first-floor bedroom with an en-suite and a self-contained flat.

The service was last inspected in August 2019, where there were breaches of regulation 9 (person centred care) and regulation 10 (dignity and respect). Patients did not have access to appropriate psychological therapies and informal patients were not always informed of their rights. The trust were told staff should assess the service for ligature risks, staff should be aware of safety incidents and lessons learned, staff should have access to a clinic room and staff should know how to access advice relating to Mental Capacity Act.

At this inspection we rated the service as requires improvement. We found 5 breaches in relation to regulation 9 (person centred care), regulation 12 (safe care and treatment), regulation 13 (safeguarding), regulation 17 (good governance) and regulation 18 (staffing). Due to the serious concerns that we found during the inspection we wrote to the provider and requested immediate actions. The trust were able to show how they had mitigated immediate risk to patients. Following this we issued the trust a warning. The trust were told they must address concerns relating to regulation 13 (safeguarding) and regulation 17 (good governance) of the Health and Social Care Act (regulated activities) Regulations 2014.

Staff did not consistently protect people from abuse. Safeguarding referrals were not always completed to protect patients from harm. Safeguarding concerns and sexual safety incidents were not appropriately managed. This meant patients were at risk of avoidable harm.

There were gaps within governance. Managers did not have adequate systems in place to monitor the assessment of risk. Staff did not always assess risks to people's health and safety, involve patients in risk assessments or mitigate risks when identified.

Managers did not have robust oversight of incidents. Incidents were not always appropriately investigated by managers and action was not always taken where concerns were identified. Learning from incidents was not always identified and embedded. Learning from incidents was not used as an opportunity for improvement and meant patients were at risk of continued harm.

Managers did not have adequate oversight of staff. Supervision and appraisal compliance was an average of 46% from May to October 2025. Clinical audits were not always completed as required. Staff did not always carry their personal alarms. This meant staff and patients were at risk of avoidable harm.

Managers did not ensure the environment was safe. There were ligature risks, fire risks and other environmental issues that were a risk to patients. This meant patients were at risk of avoidable harm.

Whilst there were adequate nursing staff, there was limited access to a responsible clinician and clinical psychologist which was not appropriate to support patients with their rehabilitation. This meant patients did not always have access to appropriate treatment for their rehabilitation.

There were some improvements since our last inspection. There was a clinic room where patients could be examined. Staff read patients their rights under the Mental Health Act. While access to the clinical psychologist was limited, there was a clinical psychologist in post.

Updated 27 May 2025

We carried out an assessment of Essex Partnership University NHS Foundation Trust, wards for people with a learning disability and autistic people between 16 July 2025 and 23 July 2025. The team visited Byron Court.

Byron Court is a mixed-gender assessment and treatment unit based in Billericay. It is commissioned for 7 beds; however, the trust is commissioned for 11 beds across Essex as part of the Essex Learning Disability Partnership. At the time of our inspection there was 1 person currently at Byron Court.

The team carried out a comprehensive inspection, covering all the quality statements in all key questions.

Byron Court was previously inspected and rated as requires improvement. Following this inspection, the rating remains requires improvement. We rated the service as requires improvement because we found a breach of the legal regulations in relation to Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Good Governance.

Governance systems and audits were not effective in identifying or addressing the areas for improvement that we identified at this inspection.

During our inspection we found there were still concerns as identified at the previous inspection relating to care and treatment records.

Since the last inspection, the service had made improvements to most of the previous concerns we had identified, where 5 out of 6 concerns were now met. We found improvements in staffing; the service now had enough permanent regular nursing and support staff to keep people safe. The service had ensured that blood glucose machines were fully calibrated. The service had ensured that staff accurately recorded administration of medicines, and that consent to treatment forms were accessible. The service had ensured staff recorded people’s vital signs in the physical health observation charts. The service had ensured that staff had access to specialist learning disability and autism training.

Updated 29 January 2024

Date of assessment 6 March to 22 April 2024: Brockfield House has 7 wards altogether and provides care and treatment for male and female patients with a mental health disorder in a secure setting. During this assessment we visited five wards: Alpine, Forest, Aurora, Fuji and Causeway Ward. This service was last inspected in 2018 and rated as good overall. We carried out this unannounced assessment because we had received information of concern relating to patient care and treatment on the forensic wards. We assessed a total of 23 quality statements from the safe, effective, caring, responsive and well-led key questions and found areas of good practice and one area of concern. The scores for these areas have been combined with scores based on the key question ratings from the last inspection. Our overall rating remains good. The wards had enough qualified, skilled and experienced staff to ensure people’s safety and meet their needs in a secure setting. The service had a proactive and positive culture of safety and minimised the use of restrictive practices. Staff assessed risks to patient's health and safety and mitigated those risks. Staff ensured medicines were managed safely. The service provided a range of treatments suitable to the needs of the patients cared for on a forensic ward. Staff actively sought information and listened to patients. The service valued a diverse workforce and worked towards an inclusive and fair culture by improving equality for staff. The trust fostered a positive culture where staff felt that they could speak up. Leaders worked well with their partners across the local system. Concerns about safety were listened to by senior leaders and safety events were investigated and reported thoroughly. However, we found a breach of the legal regulation as people were not always involved in planning their care and staff did not always maintain patients’ privacy.

Updated 26 July 2018

We rated community health services for adults as good because:

• The service managed patient safety incidents well. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. The service planned for emergencies and staff understood their roles if one should happen.
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• The service prescribed, gave, recorded and stored medicines well. Patients received the right medication at the right dose at the right time.
• The service provided care and treatment based on national guidance and evidence of effectiveness. The service monitored the effectiveness of care and treatment and used the findings to improve them.
• Staff of different kinds worked together as a team to benefit patients.
• Staff understood their roles and responsibilities under the Mental Capacity Act 2005.
• Staff cared for patients with compassion, involving patients and those close to them in decisions about their care and treatment. Staff provided emotional support to patients to minimise their distress.
• The trust planned and provided services in a way that met the needs of local people. The service took account of patients’ individual needs. People could access the service when they needed it. Response times and waiting times were monitored and senior staff took action to improve access to the service.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.
• The trust had a vision for what it wanted to achieve and workable plans to turn it into action, developed with involvement from staff, patients, and key groups representing the local community.
• The service had managers at all levels with the right skills and abilities to run a service providing high-quality sustainable care. Managers across the trust promoted a positive culture that supported and valued staff.
• The trust had a systematic approach to continually improve quality and safeguard high standards of care and treatment by creating an environment in which excellence in clinical care would flourish.
• The service had effective systems for identifying risks and planning to eliminate or reduce them. The trust collected, analysed, managed and used information well to support all of its activities, using secure electronic systems with security safeguards.
• The trust engaged well with patients, staff and the public to plan and manage appropriate services, and collaborated with partner organisations effectively.

However:

• Staff had not always completed mandatory training provided, to the trust’s target.
• Equipment was kept on the floors of large storage cupboards, which reduced effective cleaning of these areas to prevent healthcare associated infections.
• Patient records did not demonstrate that all patients received timely risk assessments such as malnutrition universal screening tool and Waterlow risk assessment.
• Records provided by the trust showed compliance with staff appraisal did not meet the trust’s target of 90%.

Updated 26 July 2018

We rated community health services for children and young people as good because:

• Staff kept children and young people safe from harm and abuse. Staff understood and followed procedures to protect all children and young people including those that were vulnerable. Staff assessed and monitored individual patient risk.
• Staff had appropriate skills, knowledge and experience to deliver effective care and treatment. There was effective multidisciplinary working across the service and care was delivered in line with national and best practice guidelines. Staff planned and delivered services to meet individual needs.
• Staff cared for children, young people and families with compassion, dignity and respect. Staff involved patients and carers in decisions and their care and treatment.
• There was a strong, visible person-centred culture and staff are highly motivated and inspired to deliver care that is kind and promotes children and young people’s dignity. Parents and children we spoke with valued their relationships with the team and felt that staff often went the ‘extra mile’.
• Staff supported the children and young people to minimise their distress.
• Complaints were effectively managed and the outcomes used to improve the quality of the service.
• The service had governance frameworks, risk management plans and quality monitoring systems in place to improve patient care, safety and outcomes.
• There was a systematic programme of clinical audits across the service to reassure senior staff of the safety of the service.
• There was a child friendly patient satisfaction survey to provide feedback.
• Staff were given opportunities for further learning and development. Several staff members described how they had developed and progressed within the organisation. Managers spoke of succession planning.

Updated 9 October 2019

Our rating of this service improved. We rated it as outstanding.

The summary for this service appears in the overall summary of this report.

Updated 26 July 2018

We rated community mental health services for people with a learning disability or autism as good because:

• Staff completed comprehensive assessments of risk that they updated when risk to patients changed. Staff ensured that if a patient suffered a crisis, there was a plan in place for the patient and carers to follow to reduce risk. Staff monitored patients on waiting lists and allocated patients according to priority of risk.
• Staff completed mandatory training and teams met the trust target for this. Managers provided regular supervision and yearly appraisals of staff’s performance. Staff had access to a trust wide leadership and development programme to increase their skills and support career development.
• Staff knew how to report incidents and what to report. Staff were trained in safeguarding and knew how to make a safeguarding referral.
• Care records were personalised. There was evidence that patients were given pictorial and easy read care plans. Staff made records of physical health assessments in the patient notes and kept GPs informed of care plans.
• We saw evidence of mental capacity assessments and best interest meetings had been held where necessary.
• Staff were caring and passionate about the care they provided. Patients we spoke with told us they were pleased with the service that they received. Carers told us the team went above and beyond to support their relative. Staff were inclusive of patients’ needs and those in the children’s service involved parents and children in the care planning and risk assessment process.
• Staff provided a rapid response to support patients who experienced sudden to deterioration in physical or mental health. Carers told us that if they called the adult’s community learning disability team, they would get a response back the same day.
• There was evidence of parents evaluating the children’s learning disability service provision at the exit interview when children were discharged.
• Staff received feedback from complaints at team meetings and supervision.
• Manager’s had an open-door policy and aside from this there was a two hour protected time slot twice per month where staff could meet with the associate director and raise any issues.
• Service users were involved in recruitment.

However:

• There was no medical cover outside the hours of 9am to 5pm for this core service. Patients care plans instructed them to telephone the police or attend local accident and emergency departments if their safety was in danger.
• There continued to be long waits for psychology and Asperger’s assessment and treatment.

Updated 26 July 2018

We rated Community-based mental health services for older people as good because:

• Overall, staffing levels were good. The trust determined staffing levels across the service and the number and grade of members of the multidisciplinary team required at each service. Overall, staffing levels were sufficient to meet the needs of the patients. Repeat appointments were held at appropriate intervals and were rarely cancelled.
• Staff could get access to psychiatrists for patients if urgently required. Staff responded promptly if they identified deterioration in a patient’s health and staff could refer to dementia review support teams, or to dementia intensive/crisis support teams.
• Staff monitored patients on waiting lists to detect and respond to increases in levels of risk. Staff used a red, amber and green traffic light system to highlight patient’s risk levels.
• Staff provided a range of care and treatments to patients. Staff held wellbeing groups for carers and patients. Kingswood Centre held a weekly dementia café in the community for patients, carers and members of the public interested to learn more about dementia. Patients were provided with information and support with employment, housing, benefits and interventions that enable patients to acquire living skills.
• We observed effective working relationships with other teams in the organisations. A newly funded role for care liaison looked to diagnose patients in care homes with dementia, and to support hospitals to prevent unnecessary admission to inpatient wards.
• Staff involved patients in care planning and risk assessment. At Brentwood and Basildon teams staff used ‘my care and my support’ plans with patients to gain the patient’s view of their needs. Examples of patient and carer involvement across the services included inviting patients and carers to care plan approach reviews. Staff knew patients’ needs and responded in a timely way.
• The buildings that accommodated the teams were clean, except one for one area that was dusty. They had good furnishings and were generally well maintained throughout. The trust had systems for cleaning, and adhered to control of substances hazardous to health guidelines. Staff followed infection control principles, including hand washing.
• Managers completed environmental risk assessments, including ligature risk assessments, except one. Patients were not left unattended in any of the rooms at all services. Staff had access to alarms when using interview rooms and staff were on site to respond to alarms.

However:

• There was a lack of oversight by managers and the wider trust in the managing of medicines and equipment on the older people’s mental health community services. Staff at the Basildon team had not checked and disposed of out of date medication. We found that four types of medication had expired, including four depot injections. This posed a risk that medication would not be effective for patients.
• We found some equipment had passed its use-by date in teams posing a risk that it would not be effective if staff used it with patients. For example, at the Harland team there were electrocardiogram pads which had expired in 2008. At Thurrock the blood pressure cuff and blood glucose strips had expired. The blood glucometer had no calibration date.
• Staff had not assessed ligature risks at Brentwood, which meant risks to patients had not been identified or mitigated.
• Across teams, patient care records were limited in information and detail. Three patient records reviewed had no care plan.
• Staff across teams did not have a consistent approach for completing physical health annual reviews and checks and records were difficult to find.

Updated 12 July 2023

Updated 12 July 2023

Updated 12 July 2023

Updated 12 July 2023