- SERVICE PROVIDER
Central and North West London NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Report from 14 July 2025 assessment
Contents
Ratings - Acute wards for adults of working age and psychiatric intensive care units
Our view of the service
We carried out a comprehensive assessment of all mental health wards for adults of working age and psychiatric intensive care units delivered by Central and North West London NHS Foundation Trust. We inspected the two wards at The Campbell Centre on 20 and 21 August 2024 and returned to these two wards and 16 others at different trust sites between 3 September and 4 October 2024.
Overall, we rated the service as Requires Improvement.
We found several areas that needed to be improved. This included practice around the reporting and recording of incidents, staffing to ensure all patient needs are met, including accessing leave from the wards, and some localised governance practices to identify and drive improvements. At The Campbell Centre we identified examples of excessive use of force used during restraint and took enforcement action around this. Where we identified areas of concern under the safe and well led will key questions, we will request an action plan from the provider.
We did find several areas of good practice, including the development of patient pathways to better support care and outcomes for patients with complex emotional needs. A large number of staff were engaged, caring and enthusiastic and had successfully delivered positive outcomes from quality improvement projects. The trust recognised staff successes and provided support, supervision and developmental opportunities. The trust employed peer support workers and ensured advocates were present and active on wards, to gather and hear patient voices and views.
Mental Health Act and Mental Capacity Act Compliance
Most staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice.
Training compliance in the Mental Health Act and the Mental Health Act Code of Practice was 86%.
Patients had easy access to information about independent mental health advocacy and patients who lacked capacity were automatically referred to the service. Patients and staff told us advocates visited the ward regularly.
Records showed staff explained to each patient their rights under the Mental Health Act in a way that they could understand and repeated this as necessary. Some patients said staff explained their rights to them and could explain these in detail. Some patients were not sure if their rights had been explained to them.
Staff were aware of important meetings such as tribunals and updated patients about them.
Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to.
Staff stored copies of patients’ detention papers correctly.
Staff understood section 17 leave and how to manage this. This is permission to leave the hospital agreed with the Responsible Clinician and/or with the Ministry of Justice. At St Charles, section 17 paperwork was not recorded clearly and completely for one patient. It was not clear whether they had signed out and signed in for each period of leave, which they are required to do.
Mental Capacity Act
Staff supported patients to make decisions on their care for themselves. They understood the trust policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity.
Staff received and kept up-to-date with training in the Mental Capacity Act. This had been completed by 94% of staff.
Staff knew where to get advice on the Mental Capacity Act. Staff in the mental health law office were able to give advice on this or seek further information from other sources.
Records showed staff assessed and recorded capacity to consent to admission and treatment and reviewed and recorded this during multidisciplinary team meetings. Staff assessed and recorded capacity to consent when a patient needed to make an important decision. When staff assessed patients as not having capacity, they made decisions in the best interest of patients and considered the patient’s wishes, feelings, culture and history. Staff kept clear, detailed records of this.
People's experience of this service
We spoke with 53 patients during this inspection. Patient feedback about staff was mixed. Some patients said staff were nice, helpful and really good. At Northwick Park, patients told us that staff made efforts to engage with them with conversations, do activities on the ward with them and resolve medicines issues. Other patients said staff were really good, amazing and helpful, were hands on and polite. Three patients described staff as approachable and good listeners. One patient said the service had saved their life.
At the Campbell Centre, patients said some staff were friendly, kind and caring. However, some patients also said they did not feel like they'd been treated with respect or dignity and some staff could be dismissive and rude. Two patients spoke to us about their negative experience of the use of force and one said they did not think they had received good care.
Feedback from carers and relatives was generally very positive.
The trust collected feedback from patients about their care through surveys. They also employed peer support workers who were present on the ward who were able to support gathering feedback about care.
Some patients told us they were not given information about the ward or shown around when newly admitted, which would have been helpful. This was supported by feedback from advocacy services.