Following its planned full inspection of our services in March 2017, the Care Quality Commission (CQC) has published its report and rating of Birmingham and Solihull Mental Health NHS Foundation Trust.
Although the overall rating of ‘requires improvement’ is disappointing, the Trust was rated ‘good’ in the majority of areas (29 out of 45) including:
- For ‘Caring’ the Trust was rated as ‘good’ overall.
- For ‘Responsive’ the Trust was rated ‘good’ overall.
- Community based mental health services for adults of working age, where the majority of our service users receive care, were rated as ‘good’ across all five CQC domains – safe, effective, caring, responsive and well-led.
- Six of the nine service areas inspected were rated as ‘good’ overall.
Whilst the CQC found many areas of good practice, we acknowledge there are improvements to be made in a number of key areas and we have already taken the following action:
- A People Strategy and Plan was approved by Trust Board in March which includes a range of initiatives to improve staff engagement and experience of organisational change.
- We have appointed a Medication Safety Officer and revised our rapid tranquilisation policy to ensure it reflects NICE guidelines.
- We are implementing stronger approaches to equality, diversity and inclusion including implementation of the Equality Delivery System (EDS2).
- Our Board Assurance Framework has been revised to focus more clearly on strategic risks.
- We are reinforcing with staff our policy on takeaway food to be clear that, whilst the Trust will promote services with at least a four star hygiene rating, service users are free to order from any outlet of their choice.
- We are developing training packages and improving staff knowledge and practice in relation to Gillick competence guidance and the Mental Capacity Act.
- We are reviewing our policy on searching of service users, which already allows some discretion in certain circumstances. However, we believe that carrying out routine searches of service users on admission and return from leave remains an essential tool in ensuring the safety of service users, staff and visitors and mitigating the risk of serious injury. This is in the context of over 1,000 physical assaults by service users on Trust staff and over 480 assaults on other service users in 2016/17. The policy has proved effective, with 148 knives and other potential weapons removed in the space of a year.
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.”
