Cambridgeshire and Peterborough NHS Foundation Trust

Updated 17 July 2025

Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) was formed on 1st June 2008, succeeding Cambridgeshire and Peterborough Mental Health Partnership NHS Trust. CPFT provides a wide range of mental health, physical health, specialist, learning disability and neuro-rehabilitation community and hospital services to a population of around 950,000 people across the East of England. Staff and services operate from more than fifty locations across the county, with main hubs of service delivery and activity based in Cambridge, Huntingdon, Peterborough and Fenland. CPFT is a designated Cambridge University Teaching Trust and a member of Cambridge University Health Partners; 1 of only 8 Academic Health Science Centres in the UK. The trust employs about 4500 staff.

CPFT are part of the local Cambridgeshire and Peterborough Integrated Care System. In December 2023 the trust was placed in segment 3 of the NHS England (NHSE) Oversight Framework. This identified the trust as having significant support needs against 1 or more of the 5 national oversight themes.

We undertook a trust level (well-led) assessment of the trust which included an onsite visit 10-12 February 2025. We also held 18 staff focus groups on and off site and observed board and committee meetings between December 2024 and February 2025.

We assessed all 8 of the quality statements in the well-led key question in this assessment.

The well-led review followed assessments of 3 of the trust’s frontline mental health services (assessment service groups - ASGs): acute wards for adults, community mental health services for adults and crisis services and health-based places of safety. The initial assessments of the trust’s services were triggered by whistleblowing concerns around patient safety and poor culture within services. We did not inspect any of the trusts community health services on this occasion. The services’ assessments identified concerns around mandatory training, supervision and appraisal, high staff vacancies and sickness, a lack of embedded learning from incidents, a lack of visibility from senior leadership, staff not feeling listened to, environmental issues and issues around record keeping.

CQC carried out enhanced engagement during 2023 and 2024 with the trust looking at culture within the organisation. This highlighted concerns around a culture of bullying and harassment within the trust, where staff didn’t feel safe to raise concerns. Concerns around significant and rapid changes within the trust executive team also prompted our well-led assessment.

We identified areas for improvement within all of the eight quality statements we assessed.These areas were as follows:

• The inspection took place at a time of ongoing instability for the executive leadership team. Moving forwards the trust must ensure the stability of the leadership team, both the executive directors and non-executive directors.
• The trust must ensure that the executive team have tailored support to develop in their roles. Succession planning had been previously lacking and needed to be prioritised.
• The trust must reset its external stakeholder relationships and agree with system partners its short and medium term priorities.
• The trust had started work on a refreshed strategy. The trust must ensure this clearly articulates the clinical strategy for physical and mental health services.
• Whilst the trust can access a wide range of data which is largely accurate and timely, there were variations between directorates and data was not always accessible or usable to drive change. There was scope to bring together data from a range of sources to identify challenged services and potential closed cultures.
• We found that many staff we spoke with during the well led assessment struggled to articulate the trusts top patient safety concerns. Whilst risks are identified we found the pace of these being addressed is variable.
• The support from corporate services (finance, HR, data and insight) for individual directorates was variable and assurance processes across the directorates needed to be reviewed and strengthened.
• Directorate leaders needed the capacity and capability to lean into the system working so they can be active partners in developing local services to meet the needs of the population.
• Significant numbers of staff didn’t feel safe speaking up and do not feel assured about the independence of the speak up guardians. The trust must take action to ensure Freedom to Speak Up processes are effective and must be able to clearly demonstrate that it has acted on concerns.
• Staff reported that senior leaders were not visible. The trust needs an engagement plan and the visits to services by members of the board need to be embedded.
• Staff continued to raise concerns about racial and disability discrimination at work. There is still a lot more to do to ensure that the draft equality, diversity and inclusion strategy is adopted, and meaningful changes take place which improve the equality and equity of staff and people who use services related to their protected characteristics under the Equality Act 2010.
• Co-production with people who use services and carers was at an early stage and was not embedded across the trust. The lead made good use of the resources available, but this is an area needing further development across the organisation.
• Responding to complaints was taking longer than the stated timescales. Whilst action was taking place, the success of these interventions needed to be monitored.
• Quality improvement at the trust appeared to have slowed. Whilst there were examples of quality improvement projects taking place this approach needs to be extended and embedded.
• Whilst managers in the trust had access to a range of learning and development to promote their leadership skills, the uptake of this was inconsistent especially for front line staff.
• Whilst action was being taken to promote environmental sustainability at the trust, there were concerns about sustainability being taken seriously by leaders, and more needed to be done to embed this in the organisation.

However, there were also positive findings across all quality statements. These areas were as follows:

• The new chief executive had been well received both internally and externally. Staff and stakeholders told us that they found him open, that they could raise concerns to him, that he had taken some immediate actions as needed and that there were some early signs of a renewed sense of direction.The board, executive directors and non-executive directors, were working together in a mutually respectful manner under the stewardship of the chair.
• All staff we spoke with were enthusiastic, committed and focussed on people who use services.
• Most staff we spoke with felt able to be candid and open during the well-led review.
• The research and innovation programmes currently being carried out by the trust were inspirational, as were the aspirations of the trust moving forwards.
• Onsite we heard about many high performing and innovative services across the trust and saw the pride staff had in them. We saw positive examples of integrated physical and mental health services as well as significant work looking at further integration moving forwards with the Cambridge children’s hospital project.
• The trust also worked successfully in partnership to support the urgent care pathway for people with physical and mental health care needs.
• We noted significant progress has been made by the mortality team on learning from deaths and further positive action is being taken to embed the learning into front line services.
• The equality, diversity and inclusion team were passionate and engaged in their work.
• The trust was making progress with its Green Plan and there was a clear direction moving forwards.

Updated 15 July 2024

During this assessment of Cambridge and Peterborough NHS Foundation Trust, the team visited the 136 Suite and Crisis and Resolution Home Treatment Team South (CRHT), both services are located at Mulberry 1 ward; Fulbourn Hospital in Cambridge; the Crisis Resolution Home Treatment Team North (CRHT) based at the Cavell Centre in Peterborough) and the FRS (First Response Service) based in Huntingdon.

We carried out this assessment due to receiving information of concern. We assessed 18 quality statements across safe, effective, caring, responsive, and well-led key questions and have combined the scores for these areas with scores from the previous inspection.

Date of on-site assessment, 7 and 8 August 2024.

During our assessment, we found concerns around:

The effectiveness of systems in place to share learning from incidents which resulted in a breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Supervision, appraisal, mandatory training, and low staffing levels which resulted in a breach of regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the evidence category findings.

Updated 19 April 2024

During this assessment of Cambridge and Peterborough NHS Foundation Trust, the team visited the community adults mental health locality teams for working age adults based in Peterborough North and South, Huntingdon and Cambridge North and South. We also visited the CAMEO South team, (Cambridgeshire and Peterborough Assessing, Managing and Enhancing Outcomes) early intervention psychosis service.

We carried out this assessment due to receiving information of concern. We assessed 20 quality statements across safe, effective, caring, responsive, and well-led key questions and have combined the scores for these areas with scores from the last inspection.

Date of on-site assessment, 12 & 13 June 2024.

During our assessment, we found concerns around:

The completeness and accessibility of patient care plans which resulted in a breach of regulation 9 (Person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The suitability of some equipment, facilities and premises which resulted in a breach of regulation 15 (Premises and Equipment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The effectiveness of systems in place to share learning from incidents which resulted in a breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Mandatory training, supervision, appraisal and staffing levels were low which resulted in a breach of regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Updated 23 January 2024

Cambridgeshire and Peterborough NHS Foundation Trust acute wards for adults of working age are based at the Fulbourn Hospital in Cambridge, and the Cavell Centre in Peterborough. The trust operated a 3-3-3 pathway model of assessment, treatment and recovery. The model consists of three days of assessment, three weeks of treatment and three months of recovery. Each acute ward had a designated function, providing services for adults aged 18 years old and over. During this assessment the team visited all six acute wards. We did not visit the psychiatric intensive care unit (PICU).

We looked at eight quality statements: learning culture, safeguarding, involving people to manage risks, safe environments, safe and effective staffing, delivering evidence-based care and treatment, Independence, choice and control and equity in experiences and outcomes.

During our assessment, we found concerns around

Mandatory training, supervision, appraisal and staffing levels which resulted in a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The accuracy, timeliness and accessibility of patient information including risk assessments, care plans, handover notes and observation records which resulted in a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Maintenance and record keeping for some equipment which resulted in a breach of regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the evidence category findings.

Updated 5 September 2019

We rated community services for adults as good because:

• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. 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 used monitoring results well to improve safety.
• The design, maintenance and use of facilities, premises and equipment kept people safe. Staff managed clinical waste well. The service controlled infection well and the service had low number of infection incidents.
• Staff kept detailed records of patients’ care and treatment, they completed and updated risk assessments for each patient and removed or minimised risks. The service used systems and processes to safely prescribe, administer, record and store medicines.
• The service provided care and treatment based on national guidance and evidence-based practice. Staff gave patients practical support and advice to lead healthier lives. Staff regularly checked if patients were eating and drinking enough to stay healthy and help with their recovery. Staff assessed and monitored patients regularly to see if they were in pain and requested pain management reviews in a timely way.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• Staff provided emotional support to patients, families and carers to minimise their distress. Staff supported patients to make informed decisions about their care and treatment. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health. Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.
• The service 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 planned and provided care in a way that met the needs of local people and the communities served. It was inclusive and took account of patients’ individual needs and preferences. People could access the service when they needed it and received the right care in a timely way.
• The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively. It was easy for people to give feedback and raise concerns about care received.
• Managers at all levels in the trust had the right skills and abilities to run a service providing high-quality sustainable care. Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. All those responsible for delivering care worked together as a team to benefit patients.
• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected. Managers used a systematic approach to continually improve the quality of its services. The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards. Staff were committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.

However:

• The service did not have robust assurance processes in relation to infection prevention and control audits. The service completed annual hand hygiene audits and did not have any formalised assurance processes in place.

Updated 21 June 2018

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

Updated 21 June 2018

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

Updated 5 September 2019

We rated the service as good because:

• The service provided mandatory training in key skills to all staff and made sure most staff had completed it. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. The service controlled infection risk well. The design, maintenance and use of facilities, premises and equipment kept people safe. Staff assessed risks to patients, acted on them and kept good care records. The service managed patient safety incidents well. The service used systems and processes to safely manage medicines.
• The service provided care and treatment based on national guidance and evidence-based practice. Staff assessed and monitored patients regularly and gave pain relief in a timely way. All those responsible for delivering care worked together as a team to benefit patients. Staff supported patients to make informed decisions about their care and treatment and followed national guidance to gain patients’ consent.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff provided emotional support to patients, families and carers, and supported them understand their condition and make decisions about their care and treatment.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and received the right care in a timely way.
• Leaders had the integrity, skills and abilities to run the service. Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Diagnostic imaging support was not consistently available during opening hours across all sites.

Updated 5 September 2019

Our rating of this service stayed the same. We rated it as good because:

• All patient areas of the wards were clean and tidy. Clinic rooms at S3 ward were fully equipped with accessible resuscitation equipment and emergency drugs, and clean and well maintained.
• There were sufficient staff to meet the needs of the patients. Overall, staff knew about any risks to each patient and acted to prevent or reduce risks. Staff identified and responded to any changes in risk to, or posed by, patients promptly. Staff used physical intervention rarely. Staff took part in de-escalation techniques and proactive preventive interventions, which included how to safely restrain a patient with low body mass index. There were effective systems in place for safe management and administration of medication.
• Services provided a range of treatment in line with best practice guidelines. Overall, there was a holistic approach to assessing, planning, and delivering care and treatment to people who use services. Staff assessed the physical and mental health needs of all patients on admission. The service had access to a range of specialists to meet the needs of the patients. Staff held regular multidisciplinary meetings to discuss patients and improve their care. Staff had a robust understanding of mental capacity and consent. We found clear records around consent to treatment and mental capacity requirements.
• We observed positive and caring interactions between staff and patients on the wards and in the community. Staff had a good rapport with patients. Staff involved patients and gave them access to their care plans. Staff contacted family members about joining multidisciplinary meetings, ward rounds, or care programme approach meetings.
• Beds were available when needed to people living in the catchment area. Staff ensured they did not discharge patients until they were ready. The trust ensured facilities promoted recovery, comfort, and dignity. Patients on wards had their own bedroom, which they could personalise. Staff provided a range of information on treatments, local services, patients’ rights, how to contact CQC, and advocacy. We saw information on how to complain displayed around the service.
• Leaders, at local level, had the right skills, knowledge, and experience to lead their teams. Staff reported they felt supported by leaders. Staff were offered the opportunity to give feedback and input into service development. S3 ward was accredited by the Quality Network for Eating Disorders.

However:

• Although staff on the wards had undertaken environmental ligature assessments, that for S3 ward had not considered risks in the garden area. Also, the garden back gate had been left unlocked. We raised this with managers during the inspection. Neither community eating disorder services had undertaken environmental risk assessments, although these were in development. The Cambridge community eating disorder service had identified risks in the patient toilet areas and staff were aware of these.
• The clinic rooms at the Phoenix Centre were disorganised and required cleaning and there were no cleaning records at the Cambridge community eating disorder service. In addition, the clinic room at the Cambridge community eating disorder service did not have disposable gloves or aprons.
• At S3 ward not all staff were routinely aware of lessons learnt from serious incidents across services.

Updated 31 March 2022

We carried out this unannounced focused inspection because we received information giving us concerns about the safety and quality of the services.

We inspected the trust’s three children and adolescent mental health wards based at Ida Darwin Hospital in Cambridge: Darwin, Phoenix and the Croft.

We did not rate all key questions of this core service, however, our rating for safe went down and is now requires improvement because:

• There were not always sufficient staff at the service. There were significant vacancies for nurses, healthcare assistants and other support staff. For the two weeks ahead of our inspection there were many occasions where the staffing levels on the ward fell below the safer staffing levels set by the trust. The trust did not record all occasions when staff were moved during shift to accommodate cover arrangements, so it was not possible to be assured that there was sufficient staffing at all times. We noted occasions were leave was cancelled due to staffing levels and there were not always sufficient staff on Phoenix ward to accommodate physical intervention.
• Not all staff had undertaken required mandatory training on Phoenix ward. Physical intervention training completion rates were 66% on Darwin, 44% on Phoenix and 32% on Croft.
• The quality of care plans and risk assessments was variable and not all incident information had been captured. For two young people who had been involved in multiple potential self-harm incidents’ the risk of self-harm was recorded as low. Not all risk assessments had been updated following significant incidents. We noted incidents within contemporaneous records that had been included on the risk assessments.
• Seclusion rooms on Darwin and Phoenix wards did not meet all of the requirements of the Mental Health Act code of practice.
• Managers had completed and updated ligature point risk assessments of all wards areas however we found that these were not available to all staff.

However:

• Most ward areas were clean, well maintained, well-furnished and fit for purpose.
• There had been minimal use of physical intervention or rapid tranquilisation at the service in recent months. There had been no use of seclusion since August 2021. Physical health checks had been undertaken following restraint and rapid tranquilisation.
• Staff knew what incidents to report and how to report them. Managers debriefed and supported staff after any serious incident and investigated incidents thoroughly. Children, young people and their families were involved in these investigations where appropriate. Staff received feedback from investigation of incidents and were included in learning discussions looking at improvements to care. There was evidence that changes had been made as a result of feedback.

How we carried out the inspection

• Reviewed the environment of all wards
• Spoke with the service director, service manager and modern matron for the child and adolescent mental health service
• Spoke with the deputy ward manager and clinical team leader for Darwin and the nurses in charge of Croft and Darwin wards
• Spoke with key stakeholders including the East of England Provider Collaborative
• spoke with four other staff
• spoke with three children and young people and joined a community meeting on Darwin Ward
• spoke with two young peoples’ parents
• looked at care and treatment records for five young people
• reviewed incident and physical intervention records
• reviewed staffing rotas for the three wards
• reviewed observation records
• and reviewed a range of policies and procedures, data and documentation relating to the running of the service.

You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection

Updated 5 September 2019

Our rating of this service improved. We rated it as good because:

• The service provided safe care. Clinical premises where patients were seen were safe and clean. The number of patients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each patient the time they needed. Staff managed waiting lists well to ensure that patients who required urgent care were seen promptly. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The teams included or had access to the full range of specialists required to meet the needs of the patients. Managers ensured that staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
• Staff understood the principles underpinning capacity, competence and consent as they apply to children and young people and managed and recorded decisions relating to these well.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
• Staff assessed and treated patients who required urgent care promptly and those who did not require urgent care did not wait too long to be assessed. The criteria for referral to the service did not exclude children and young people who would have benefitted from care.
• The service was well led and the governance processes ensured that procedures relating to the work of the service ran smoothly.

However:

• Waiting times from referral to treatment start exceeded 18 weeks for 24% of patients.

Updated 21 June 2018

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

Updated 13 October 2015

We gave an overall rating for community-based mental health services for older people of good because:

• The support provided by older persons CMHTs, CRHTs, day therapy service and memory clinic was thoughtful, respectful and considered patients individual needs. The teams worked closely with carers and relatives and with other agencies. Teams were appropriately staffed, and where there were vacancies appropriate arrangements were in place to manage these.

• Risk assessments were undertaken on every patient during the initial assessment. This information was reviewed regularly. However, in one instance we found that the risk assessment had not been updated. All incidents were reported and staff had opportunities to discuss and learn from these. However, managers at some sites did not have access to detailed information relating to incident reporting within their team and two staff reported that when reporting incidents they were not always clear how to rate the incident.

• Comprehensive assessments were completed in a timely manner, and care records were up to date. However, a small number of care records did not evidence that patients had been given a copy of their care plan. Some care plans were not recovery orientated, did not consider holistic needs or contain the patients’ views. One patient we spoke with told us that they were not aware of the out of hours arrangements for contacting services.

• Staff were using NICE and other best practice guidance. Each team was made up of the full range of disciplines, who were regularly supervised and supported to undertake appropriate training. Staff demonstrated a good understanding of the MHA and MCA. Urgent referrals were seen quickly and non-urgent referrals within acceptable timescales.
• The trust had effective governance procedures in place. Key performance indicators were used to gauge the performance of individual teams, and staff had the ability to submit items to the directorate and trust risk registers. Staff spoke highly of their managers and their supportive teams. Staff were open and transparent with patients when things went wrong. Some teams were involved in innovative research programmes. Whilst a wide range of information leaflets were available at each site we visited, these were not available in a range of formats or languages.

Updated 21 June 2018

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

Updated 21 June 2018

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

Updated 22 July 2022

We carried out this unannounced focused inspection of the liaison psychiatry service based at Peterborough City Hospital as part of a larger review of integrated care across the region. The inspection was focussed on the urgent and emergency care patient pathway and any barriers to discharge or transfer of patients with mental health needs out of the acute general hospital. We did not inspect all aspects of the key questions.

The liaison psychiatry service is part of the Cambridge and Peterborough NHS Foundation Trust mental health crisis service. The aim is to provide assessment, diagnosis and treatment for emotional and psychiatric problems for patients attending local general hospitals. Teams were based at Peterborough City Hospital in Peterborough, Addenbrooke’s Hospital in Cambridge, and Hinchingbrooke Hospital in Huntingdon. We only visited the liaison psychiatry service based at Peterborough City Hospital.

The liaison psychiatry service has two arms, the team who assess people with mental health concerns arriving at the urgent and emergency care department and the team who cover the Peterborough City hospital inpatients. The urgent and emergency care team role is front facing within the department assessing patients’ immediate needs and acts to gatekeep beds within the local mental health services. The inpatient arm of the service focusses on assessing and managing the mental health needs of those admitted to the acute hospital.

We did not inspect any other parts of the mental health crisis service or health-based places of safety core service at this time as they did not form part of the integrated care review.

We did not rate this service at this inspection as it was part of a review looking at urgent and emergency care systems. The previous rating of good for the mental health crisis service or health-based places of safety core service remains. We found:

• The liaison psychiatry team were easy to access. Staff assessed patients promptly. Those who required urgent care were taken onto the caseload of the liaison psychiatry team immediately. Staff and managers managed the caseloads of the liaison psychiatry team well. The services did not exclude patients who would have benefitted from care.
• The number of patients on the caseload of the liaison psychiatry service and of individual members of staff, was not too high to prevent staff from giving each patient the time they needed.
• Staff followed good practice with respect to safeguarding.
• Staff working for the liaison psychiatry service assessed patients and developed holistic, care plans in collaboration with families and carers.
• Managers ensured that staff received supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• The service was well led, and the governance processes ensured that procedures ran smoothly.

However,

• Staff mandatory and required training in some areas was very low.
• Staff clinically assessed and managed patient risk well but there was inconsistent assessment and recording of patient risk.
• Staff had not fully reinstated clinical audit following cessation during the COVID-19 pandemic to evaluate the quality of care they provided.
• The liaison psychiatry team included but did not have access to the agreed psychologist specialist required to meet the needs of the patients.

During the inspection visit, the inspection team:

• Visited the liaison psychiatry service based in the urgent and emergency care department at Peterborough City Hospital.
• Spoke with 17 staff members; including the service lead, doctors, specialist nurses, clerical workers and managers.
• Observed one visit by staff to an inpatient who had been referred to the liaison psychiatry service.
• Spoke with one patient.
• Observed one handover meeting.
• Reviewed five care records of people referred to the liaison psychiatry service.
• Looked at a range of policies, procedures, meeting minutes and other documents relating to the running of the liaison psychiatry service.

Updated 13 October 2015

We gave an overall rating for long stay/rehabilitation mental health wards for working age adults of good because:

• Patients we spoke with were very positive about the wards and the care they received from staff and told us they were involved in their care, were listened to and treated with kindness and respect.

• Staff morale was high with staff positive about the leadership of both the trust and their line managers. There were good systems in place to monitor staff performance and the productivity of the ward.

• There was good management of risk, learning from incidents and complaints. Staff shortfalls were managed safely with an active recruitment programme for staff vacancies. Staff were up to date with mandatory training and were able to undertake further training; for example, four nurses had trained in tissue viability and wound management.

• Patients had a full range of activities.

However:

• There was a general lack of psychology input which meant staff did not always have sufficient input to help them manage more complex and challenging patients.

• Oak 4 did not have a dedicated low stimulus/de-escalation area.

Updated 21 June 2018

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