NSFT "moving in the right direction" following positive CQC report
The Care Quality Commission (CQC) inspected the mental health Trust in October and November last year and today gave its verdict, saying out of 48 areas examined it had improved in 22, stayed the same in 21 and was worse in five. Overall, NSFT is now "Outstanding" in one service (The Dragonfly Unit at Carlton Colville – a young people's psychiatric unit – which was rated in 2018), "Good" in four, five "Require Improvement", and one is "Inadequate" out of its 11 core services.
The CQC gave NSFT an improved overall rating of "Requires Improvement", having been considered "Inadequate" just over a year ago, the lowest ranking out of the four awarded by the CQC.
NSFT Chief Executive Jonathan Warren, who took up post in April last year, said: "This is a move in the right direction and is down to the hard work and dedication of staff. We are also starting to see some of the improvements we are putting in place come to fruition.
"However, we are under no illusions and recognise that the next 12 months and beyond are crucial in not only fully embedding changes already made, but in building upon them so that next time we are inspected, we have shown further significant improvement.
"Our improvement plan, which has regular oversight by our regulators, will now be refreshed and informed by working closely with all our services to determine our priorities for the next six months.
"Our ambition remains for NSFT to deliver high quality and effective services for our patients and be in the top quarter of mental health trusts nationally for quality and safety by 2023 and the CQC confirms we have made a good start."
NSFT scored particularly highly in older people's services, both on wards and in the community, where they were consistently rated "Good". Also, staff were rated "Good" for being caring in seven out of eight areas.
One service – specialist community mental health services for children and young people – was rated "Inadequate" overall. Mr Warren said: 'It is disappointing that we still have one service rated inadequate. We are working closely with commissioners to reduce waiting lists for young people and are transforming the way we tackle mental ill health in young people. The service is on a long improvement journey, but I believe we're moving in the right direction and come the next CQC inspection, we will start to see that reflected in its rating."
NSFT became the only mental health Trust to be placed in special measures in 2015, but was taken out a year later and then placed back in again during 2017. Mr Warren said: "We are hopeful that if we keep up our rate of improvement, the Trust will come out of special measures during 2020. But for now, we welcome the extra support we receive, and we want to make sure that when we come out next time, we come out for good."
Case Study 1 – Julian Hospital, Norwich
The Julian Hospital in Norwich has a total of 54 beds across four wards for older people with mental health needs and provides assessment and treatment for people who live in Norfolk and Waveney.
Andrew Lillywhite, the hospital's Modern Matron, said: "Clinicians across the multidisciplinary team identified and implemented quality initiatives that have improved the delivery of care for patients and carers.
"These initiatives have been led by the staff who are passionate about their work and include implementing Red2Green across all four wards in March last year, which is a system to identify clinical and social delays in a patient's journey. This has had a significant positive impact on bed flow, the prevention of delays and the overall patient experience from admission to discharge.
"Our nurses, occupational therapists, psychologists and support workers introduced Dementia Care Mapping in 2018 which involves continuously observing the behaviour of people with dementia and the care they receive. It aims to capture small things which lead to happiness or distress, and we use this information to enhance the care provided.
"The Julian Hospital was the first mental health provider to introduce a coaching model called CLiP where qualified staff and a practice facilitator coach students undertaking their degree in mental health nursing, and which has helped with the recruitment and retention of nurses at our hospital."
Case Study 2 – Bury South IDT's Older People's Team
The Bury South Integrated Delivery Team (IDT), which is based in Hospital Road, Bury St Edmunds, has an Older People's Team which provides community mental health support to people living in Bury St Edmunds, Sudbury and Haverhill, and the surrounding area.
The team supports individuals who experience mental health challenges, including dementia, psychosis and depression, and also their families. It consists of mental health nurses, a social worker, a psychologist, a cognitive behavioural therapist, an assistant psychologist, a support worker, psychiatrists, admin support and a team manager. This multidisciplinary approach ensures that the support received is person-centred and effective.
Lauren Talbot, a senior mental health nurse in the team, said: "Providing a person-centred approach to care and support and assessing any physical, psychological or social need enables the individual to receive the most appropriate care, support and treatment.
"The Older People's Team ensures that individuals and their families are involved in the effective delivery of the service. We have close links with the Trust's research team, Dementia Together Suffolk, local universities and voluntary organisations and liaise with GPs, social services and other IDT pathways and teams.
"We take pride in working well together and supporting each other, which is achieved by sharing knowledge, skills and experience. Working in this way ensures that the individual and their family receives the best service possible from the team.