Concern over care for mental health patients

LCFT CEO Heather Tierney Moore
LCFT CEO Heather Tierney Moore

The trust that provides mental health services in Lancashire has been told it must make improvements following an inspection earlier this year.

Lancashire Care NHS Foundation Trust (LCFT) has been rated as “Requires Improvement” by the Care Quality Commission (CQC), although it was rated as “Good” for being caring and responsive.

We were realistic about the fact there are challenges in some parts of the organisation and issues that need to be resolved and thought it was important to be open with the CQC about that from the onset

Heather Tierney-Moore, chief executive at LCFT

Staffing issues, quality of communication, meeting patients needs, training, and risks to suicidal patients were all flagged up as needing urgent attention.

A spokespersom for the trust said the CQC saw approximately 30 per cent of its services and spoke to around 300 people. It added that a number of the issues had already been addressed and some immediate remedial action had taken place.

A team of inspectors, specialist advisors and people with experience of using services or caring for someone who uses services spent four days at the trust in April and May 2015.

Inspectors noted that the trust had revised its governance committee structure shortly before the inspection, but changes had not bedded in and the trust was experiencing problems associated with any major restructuring but had yet to realise the potential benefits.

CQC concluded that the recent changes had adversely affected the quality of communication links between the board and clinical directorates.

Many of the children’s services were being delivered from locations not owned by the trust, and the locations were not suitable environments for the services they were delivering. The trust faced challenges with staffing levels across mental health wards following the relocation of some wards and in some services, there were not enough experienced staff to meet patients’ needs.

In forensic wards, patients’ needs were recognised but not always met owing to staff shortages, meaning inconsistent access to meaningful activities and leave.

CQC found gaps in service provision for young people aged 16-18, including the lack of an appropriate pathway for patients moving from Child and Adolescent Mental Health Services to adult services. Compliance with compulsory training, appraisals and supervision was inconsistent across all services and the trust was not meeting its own targets.

In acute wards and psychiatric intensive care units, there was a significant shortfall – just 11 per cent of staff had completed mandatory training. While waiting times for community services were reasonable, people who needed an appointment with the chronic fatigue service were waiting 60 weeks on average, when the expected wait was supposed to be six. Waiting times for children’s services were improving.

Heather Tierney-Moore, chief executive at LCFT said: “As an organisation we are taking the inspection process and the feedback extremely seriously and we welcome the opportunity to learn and improve. We were realistic about the fact that there are challenges in some parts of the organisation and issues that need to be resolved and thought that it was important to be open with the CQC about that from the onset.

“The Trust has used this first major inspection under the new format as a learning opportunity and in some respects, the outcome is helpful in that it will provide a clear focus for us to make the necessary improvements, with the support from our commissioners.”

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