The BIRMINGHAM and Solihull Mental Health NHS Foundation Trust has been rated a lowly ‘Requires Improvement’ overall.
The rating comes from the Chief Inspector of Hospitals following an inspection by the Care Quality Commission (CQC) in March.
The trust provides mental health services to 1.2 million people, from children to the elderly, in the Solihull and West Midlands region, operating from over 50 sites.
The trust’s previous overall rating was ‘Good’.
It is now rated as ‘Good’ for being caring and responsive, but it ‘Requires Improvement’ for being safe, effective and well led.
CQC’s Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said: “Our inspectors found that the trust needed to make a number of improvements to bring its services back to a level that would earn a rating of good overall.
“It was disappointing to see that the trust’s rating had declined from good to requires improvement and the trust must now ensure improvements are made in order to provide services that are safe, effective, caring, responsive and well-led.
“Feedback from staff and evidence from the most recent NHS staff survey suggested a disjoint between the board and staff at service level. Staff groups in several areas reported feeling under-valued and being unheard concerning key decisions and service re-design.
“The Board Assurance Framework did not focus on strategic risks and instead was an extension of the corporate risk register. This meant that the board were unable to provide robust evidence of an understanding of the trust’s corporate risks.
“The oversight and safety of medicines management was compromised as the trust did not have a medicines safety officer in post. The trust policy concerning rapid tranquilisation was also out of date and did not reflect updated guidance from the National Institute for Health and Care Excellence.
“However, we found some areas of good practice including the trust’s effective involvement with external stakeholders in the planning and delivery of services. The trust had embarked on a partnership with other providers to establish a forensic pathway with support from NHS England.
“Staff throughout the organisation, were caring, compassionate, kind and treated patients with dignity and respect. Feedback from patients and carers was positive and highlighted the staff as a caring group.
“Throughout our visit, we saw staff interacting with patients in a positive, friendly and respectful manner and most patients were positive in their views of staff. We also observed staff speaking about patients positively in referral and multidisciplinary meetings.
“The trust leadership is aware of what it needs to do to bring about improvement in the areas identified. We will continue to monitor the trust and our inspectors will return at a later date to check on what progress has been made.”
TRUST RESPONSE
John Short, Chief Executive at the Trust, said:
“Although our overall rating is ‘requires improvement’, we are pleased that the CQC has rated the majority of our services as ‘good’.
“To be rated as ‘good’ for being caring and responsive is testament to the commitment of our staff to meet the individual needs of our service users and their carers, particularly in the context of the significant re-design of services required over the past two years as a result of changes to how services are commissioned. We are proud that inspectors found that staff throughout our organisation were caring, compassionate, kind and treated patients with dignity and respect and that feedback from patients and carers reflected this. The CQC’s report also highlights that external partners and stakeholders were positive about the Trust’s role in addressing the challenges faced by the local health economy. This is particularly evident in the work we do in partnership on crisis care, for example through innovative iniatives such as Street Triage, the RAIDplus NHS Test Bed and the MERIT vanguard. It is therefore disappointing that the report does not reflect some of the positive outcomes of our work to ensure that people in crisis receive appropriate care, such as the fact that Birmingham is the only city in the UK where no person detained under Section 136 of the Mental Health Act was taken to a police cell over a 12 month period.
“However, we recognise that the CQC has identified some areas where we did not meet the high standards we set ourselves. Since the inspection, work has already been completed in a number of key areas and is under way to address the other concerns raised. We are continuing dialogue with the CQC on our approach to searches, as protecting our service users and staff from harm is of paramount concern to us.
“We look forward to a future visit from the CQC to carry out a further inspection and see the progress we have made.”
