Maudsley gets ‘good’ rating from inspectors, while problems persist at intensive care wards

News Desk (27 May, 2017) Health Emergency services

CQC inspectors took issue with the Trust's use of the 'prone' method used to restrain patients face down on the ground

7974Maudsley Hospital, part of South London and Maudlsey NHS Trust

The South London and Maudsley NHS Foundation Trust (SLaM) has been given a ‘good’ rating by inspectors from the Care Quality Commission.

The Trust, which runs sites across south London, including the Maudsley Hospital in Camberwell, was visited by inspectors from the CQC in January.

They rated the Trust as ‘Good’ in many areas, such as child and adolescent mental health wards,  and ‘outstanding’ for community mental health services for people with learning disabilities or autism.

But they gave the trust a rating of “requires improvement” in some areas, despite commenting that it had addressed the “most serious issues” identified in 2015.

Staff vacancy rates were over 40 per cent on seven acute wards, leading to cancellations of patient activities. The highest was a 49 per cent at the Powell ward in Ladywell, Lewisham.

Inspectors also objected to Trust’s staff using the “prone position” to restrain mental health patients.

Between May 2016 and January, 360 patients were restrained using the prone method, which involves holding a patient face-down to the ground with two people restricting the patient’s arms and legs. The Department of Health introduced rules in 2013 to limit its use following debates on whether it can restrict patients breathing, or whether it was a needed to keep staff safe. The CQC commented that the Trust had improved its recording of prone-restraint cases, whereas in 2015 “incidents of restraint were not being accurately recorded”.

Patients on four acute wards at Maudsley Hospital raised concerns about pest control, which the trust had “struggled to keep under control”, despite insect infestations at the Aubrey Lewis 3 ward in May 2016.

Inspectors noted some staff had not completed training for care of patients with autism and learning disabilities, although new training regimes were “being rolled out across the wards”.

However, the inspectors complemented staff on their high morale, and said the majority of patients found them “kind and caring” and “offered practical and emotional support”.

The inspectors found “good working relationships” between ward staff and home treatment teams, which “supported the delivery of effective patient care”.

The report also said the Trust had “significantly reduced” the number of patients being cared for in hospitals outside their local area.

Overall there were sixteen out of 38 points on which the Trust had not sufficiently improved since inspections in 2015, in its services Lewisham, Lambeth and Croydon, as well as Maudsley Hospital in Camberwell.

Responding to the CQC report, a SLaM spokesperson said: “We welcome the CQC’s findings that our acute wards for adults of working age and psychiatric intensive care units have improved so they are now rated ‘good’ for being caring and responsive. Due to the hard work of our staff, this means that the trust has no ‘inadequate’ ratings.

“We work constantly to improve our care and the CQC has outlined areas that we need to improve. Our Clinical Director and Service Director are using the report to work with staff to embed the many improvements already underway. Our priority is safe and compassionate care and our focus is on supporting our staff to be able to prevent and to de-escalate incidents. We are paying particular attention to understanding the use of restraint in our services so that we can improve the experience and safety for people who use services.

“The CQC’s report provides us with an agenda for making these necessary improvements. We are developing an action plan which we will submit to the CQC at the end of May.”

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