Learning disability and autism wards run by the Cumbria, Northumberland Tyne and Wear NHS Trust (CNTW) have been hit with a rating of "requires improvement" after an inspection from the Care Quality Commission (CQC) in May this year.
In its criticism, the CQC highlighted staffing issues and that staff did not necessarily "receive the right training". The independent regulator also highlighted how one patient looked after by the trust was subject to "restrictions which were not proportionate" to the level of risk they posed, while people looked after in seclusion did not always see their privacy and dignity respected.
Additionally, the CQC inspection team found that it was not always clear in patient records in some cases why a patient had initially been prescribed anti-psychotic medication. Another criticism included: "The use of restrictive interventions was high and there was a high proportion of prone restraint."
However, the regulator found that notices to improve in certain areas from previous inspections had been met, while feedback was largely positive from service users and families.
CNTW runs mental health and disability services throughout the region. Nine wards - Rose Lodge in Hebburn, a learning disability and treatment service at the Carleton Clinic in Carlisle, and seven further facilities at Morpeth's Northgate Hospital - were inspected. Rose Lodge had previously been told to improve after the CQC found staffing there was "unsafe".
Debbie Ivanova, CQC director for people with learning disabilities and autistic people, said: "When inspectors visited the wards for people with a learning disability or autistic people, they found leaders were visible and approachable and worked flexibly to understand the service, support staff and meet people’s needs.
"Also, staff felt respected and supported by managers and colleagues. However, it was concerning that there wasn’t enough staff on Cheviot ward to keep people safe and meet their needs. People told us that when they were short staffed, they couldn’t do their planned activities and therapies which was disappointing for them."
She added that not all seclusion rooms were fit for purpose, highlighting that some wards had issues with nurse call alarms, accessibility issues, and even issues regulating the temperature. The trust has acknowledge these issues and is building new wards to address this.
Ms Ivanova added: "Although most of the feedback about the service was good, improvements are needed across the wards to improve patient care. Leaders know what action they must take, and we will return to check on progress.”
James Duncan, CNTW's chief exec said the trust welcomed the report, "fully accepted" the findings and would "respond positively" to address the issues raised. He added: "We have already put in place actions to address environmental concerns, through the development of purpose-built facilities for many of these wards, which will open early in 2023.
"We are very clear about the actions we need to take as an organisation, but I am pleased that the report recognises the kind and compassionate care given by our staff. The last two years have presented challenges that we have never seen before, and the teams across our services have done so much to rise to those challenges."
Mr Duncan said he was pleased the CQC had recognised the improvements previously made, and he said the trust had shown it can respond to concerns raised.
"While I give my full assurance that we recognise and will take action to ensure that the concerns identified in this report are addressed," he added. "I am proud and grateful to the teams working across these wards for their dedication in providing compassionate, person-centred care in often difficult circumstances."
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