South London and Maudsley NHS Foundation Trust has been rated ‘good’ overall but acute wards and community-based care still ‘require improvement’ over safety concerns.
Inspectors returned to visit acute wards for adults and psychiatric intensive care, community-based mental health services for adults, long stay/rehabilitation mental health wards and perinatal services throughout April and May of this year.
Last November, the healthcare watchdog branded the trust’s acute wards ‘inadequate’ despite a ‘good rating’ overall as the trust struggled to cope with high demand but limited resources.
The latest report, published on Tuesday, July 30, showed that the trust had achieved significant improvements.
It praised a ‘high calibre board’ and said the number of matrons had increased to help teams give high-quality care.
Patients were receiving care closer to home and the enthusiasm and commitment of staff was praised, as was a focus on black and minority ethnic staff and ensuring diversity at all levels.
But some of the most pressured areas of care – including acute wards – are rated ‘requires improvement’.
Although patients were less likely to face delays in being discharged, and the use of the face-down prone restraint had markedly dropped, there were some cases where care guidelines were not being followed and the sheer number of patients needing support also posed difficulty.
Dr Paul Lelliott, Deputy Chief Inspector and lead for mental health for the CQC said: “There is some very good care provided by South London and Maudsley NHS Foundation Trust and there have been improvements since our last inspection.
“There are some breaches of regulations and I’d like to see them addressed quickly.
“Patients are still affected by the ongoing extreme pressures on the acute care pathway.
“Bed occupancy remains above 100 per cent on most wards, which meant staff might not have been able to manage the care of patients safely.
“There was not always a bed available for someone who needed one.
“The trust had placed 300 patients in out-of-area beds between February 2018 and December 2018”.
Responding to the announcement from the CQC, Beverley Murphy, director of nursing at the Maudsley, paid tribute to the trust’s staff: “This is a very positive result and only possible because of the hard work of both frontline staff and all those who provided support to ensure that improvements could be made.
“We are proud of our staff and we are grateful for their continued support.”
She went on to say: “Although there is more still to do to improve in the safety domain, we have shown over the last year our ability to deliver significant improvements and we are confident that we can make the changes we need.
“Most importantly, the improvements we have delivered have made a real difference for the people who use our services.”
How the trust is rated by area and by service
- Overall rating for the trust – Good
- Are services safe? Requires improvement
- Are services effective? Good
- Are services caring? Good
- Are services responsive? Good
- Are services well-led? Good
- Wards for people with a learning disability or autism – Outstanding
- Acute wards and psychiatric intensive care units – Requires Improvement
- Community-based mental health services for adults of working age – Requires Improvement
- Perinatal services – Good
- Long stay or rehabilitation mental health wards – Requires Improvements
- Forensic inpatient or secure wards – Good
- Community-based mental health services for older people – Good
- Mental health crisis services and health-based places of safety – Good
- Specialist eating disorder services – Good
- Wards for older people with mental health problems – Good
- Specialist community mental health services for children and young people – Good
- Community mental health services for people with learning disabilities or autism – Outstanding
- Child and adolescent mental health wards – Good