NHS Trust rated inadequate for fourth time amid concerns about quality of care and patient safety

A mental health trust has been rated as inadequate for a fourth time as inspectors warned that it must improve.

Health watchdog the Care Quality Commission (CQC) inspected Norfolk and Suffolk NHS Foundation Trust (NSFT) in November and December amid concerns about the quality of care and patient safety.

The CQC’s report said that 115 “unexpected or potentially avoidable deaths” were reported between September 1 2019 and September 30 2021.

Inspectors found that the service did not have enough medical staff and staff “were not up-to-date with all the basic training to keep people safe from avoidable harm”.

The report said the trust “had not taken action to reduce and remove ligature risks it had identified where it would have been reasonable and practicable to do so”.

Following the inspection, the CQC’s overall rating of the trust dropped from “requires improvement” to “inadequate”.

The trust closed two of its wards to new patients following initial feedback from the CQC, after the watchdog considered taking urgent enforcement action while the inspection was under way.

It was rated as inadequate for being safe, effective and well-led, but was rated as good for being caring and as “requires improvement” for being responsive to people’s needs.

Care had improved in some areas, with wards for people with a learning disability or autism now rated as good.

Craig Howarth, CQC head of inspection for mental health and community services, said: “Although the quality and safety of patient care in most of the services we inspected at Norfolk and Suffolk NHS Foundation had deteriorated since our previous inspection, there were areas where we found improvement.

“A significant factor behind the trust’s shortcomings was its lack of enough staff to meet patient need, a problem many mental health trusts are encountering.

“The trust needs to ensure its leaders have effective processes to consistently monitor teams, ensure compliance with training targets, understand issues affecting patient care and do more to support staff on the front line.

“However, we found staff were more engaged, compared to our previous inspection, driven by a vision of what the trust wanted to achieve for its patients.

“This impetus had improved patient care on its wards for people with a learning disability or autism.

“The trust must embed this culture of improvement to turn around its worse performing services.”

He said he was “concerned restraint was used too frequently and incorrectly on child and adolescent mental health wards”.

The CQC has served the trust a warning notice, requiring it to make improvements to ensure patient safety within a legally binding timetable.

“If our next inspection finds insufficient improvement, we will take further enforcement action to protect people from the risk of avoidable harm and hold the trust’s leaders to account,” said Mr Howarth.

The CQC will inspect the trust again within the coming months to determine whether improvements have been made.

Copyright (c) PA Media Ltd. 2022, All Rights Reserved. Picture (c) Peter Byrne / PA.