East London NHS Foundation Trust

Ratings - Child and adolescent mental health wards

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Good

Our view of the service

We carried out a comprehensive assessment of the East London NHS Foundation Trust, Child and adolescent mental health inpatient wards across two locations: The Coborn Centre for Adolescent Mental Health in Newham, and Evergreen Unit for Adolescent Mental Health in Luton.

We inspected this service as part of our ongoing comprehensive mental health inspection programme.
The units deliver the following regulated activities:
• Treatment of disease, disorder or injury
• Diagnostic and screening procedures; and assessment or medical treatment of persons admitted under the Mental Health Act (MHA) 1983
The Coborn Centre and the Evergreen units provide specialist Tier 4 Child and Adolescent Mental Health Services (CAMHS) inpatient care for adolescents experiencing severe and complex mental health disorders. The service delivers assessment, care and treatment for young people whose mental health needs and associated risks cannot be safely or effectively managed within community settings. Care is delivered using a community-oriented model underpinned by trauma-informed practice, co-production with young people, and active involvement of parents and carers in care planning and decision-making processes.
The units accept referrals for young people aged 13 years and above. At the time of inspection, the youngest admitted patient was 14 years old. There were no patients aged 18 years on the wards during the inspection
The service provides care and treatment for a range of mental health presentations including emotional dysregulation, depressive disorders, psychosis and eating disorders. Young people admitted to the service commonly present with significant functional impairment and elevated levels of risk to themselves and/or others.

We visited the following units as part of the assessment:
Four units at the Coborn Centre for Adolescent Mental Health (Newham, East London)
• Nova Ward (previously Coborn Acute Ward) 12 - bed acute inpatient
• Pluto Ward (previously Coborn PICU Ward) 4 - bed Psychiatric Intensive Care Unit (PICU)
• Galaxy Ward 11 - bed Psychiatric Intensive Care Unit (PICU)
• Day Unit for 6 young people
The Evergreen unit (Luton)
• 8 - bed adolescent inpatient ward.
The East London NHS Foundation Trust, child and adolescent mental health Inpatient wards were last inspected in June 2016, at which time the service was rated as Outstanding overall. The most recent Mental Health Act review visits took place at the Coborn Center Unit in March 2024 and at the Evergreen unit in May 2023 respectively.
During this assessment, the inspection team:
• Visited 4 wards and 1 day unit across the 2 hospital sites
• Carried out an environmental tour of each of the wards and observed staff supporting and interacting with the young people.
• Spoke with 16 young people
• Spoke with 5 carers
• Spoke with 48 members of staff. This included ward managers, consultant psychiatrists, senior leadership team, mental health law team, support workers, people participation lead, deputy director, lead psychologist, lead social worker, assistant clinical director, registered nurses, clinical lead nurse, nurse associate, health care assistants, art and drama therapist, care managers, education lead, practice lead, life skill recovery worker.
• We attended multi-disciplinary meetings, senior management group (SMG) daily meeting, interface meeting with the North Central and East London (NCEL) Provider Collaborative, risk management meetings, safety huddles, ward rounds community meetings, education and activities.
• We looked at policies and procedures related to the running of the service.
• We reviewed the restraint tracker,
• We reviewed 7 seclusion records
• 16 electronic care records including NG tracker, incidents review and safeguarding records.

The service demonstrated a strong commitment to therapeutic recovery through the delivery of psychological interventions, educational provision, occupational therapy and structured therapeutic activities, alongside pharmacological treatment where clinically indicated. We observed strong and effective multidisciplinary working across both sites. Meetings we attended were collaborative, well-structured and clearly focused on the best interests of the young person. There was clear communication between disciplines, including psychiatry, psychology, nursing, occupational therapy and education staff, enabling a comprehensive and shared understanding of risk and care needs. Staff demonstrated a proactive and coordinated approach to risk management, with thorough discussions of risks, triggers and care planning interventions.

Interactions between nursing, the multidisciplinary team and the wider clinical teams were consistently positive, with good rapport observed and reflected in feedback from young people. Staff across both services demonstrated a shared commitment to delivering person-centred care. The integration of the Coborn Centre and Evergreen Unit supported a consistent approach to ethos, values and governance, strengthening collaboration and alignment across sites.

The service also demonstrated a strong commitment to learning, improvement and innovation. There was evidence of well-established quality improvement work, including initiatives to reduce restrictive practices, improve therapeutic engagement and enhance patient experience. These initiatives were supported by co-production with young people and reflected a proactive approach to continuously improving care and outcomes.

People's experience of this service

During the inspection, we spoke with 16 young people about their experiences of care and treatment within the service. Feedback was positive, and young people consistently described staff as caring, supportive and responsive to their needs. Overall, feedback from young people indicated that the service was caring and supportive, with staff generally viewed as engaged and responsive to young people’s needs.
Young people felt able to ask staff questions and said staff responded quickly when support was needed. Several young people described staff as “kind”, “caring” and “wonderful”, and said they felt supported when they became unwell.
Young people also spoke positively about the flexibility of activities available on the ward and told us they were supported to access community leave and going for walks. Feedback highlighted that staff engagement, access to education, therapeutic groups and opportunities for activities contributed positively to their experience of care.

Most young people told us they felt safe within the ward environment, and we did not identify significant concerns relating to safety during feedback sessions.
Some young people identified areas for improvement, particularly in relation to the quality and choice of food, with requests for greater variety, and increased access to leave and outdoor spaces, especially during weekends.

Mental Health Act and Mental Capacity Act Compliance
The training data indicated that most staff had undertaken relevant statutory training relating to the Mental Health Act (MHA), Mental Capacity Act (MCA, including modules specific to children and young people. Staff consistently demonstrated a good understanding of the principles of both the MHA and MCA and how these should be applied in practice. Overall compliance with MHA training was high at 93%. Compliance with the Mental Capacity Act training for CAMHS/Children’s Health was slightly lower at 83%, however, key clinical roles were fully compliant, with approved clinicians achieving 100% completion of the combined MHA and MCA training. This strong level of training compliance, alongside staff knowledge, supported safe and lawful practice, ensuring that young people’s rights were upheld and that care and treatment were delivered in line with statutory requirements.

Overall Ratings GridOverall-

Safe

Effective

Caring

Responsive

Well-Led

Child and adolescent mental health wards

Good

Good

Good

Good

Good