Welsh Gov publish results of mental health ward spot checks

The spot checks, which followed and built on a series of unannounced reviews of care for older people being treated on medical wards in district general hospitals last year, focused on seven fundamental aspects of care:

• Eating and drinking;
• Use of restraint and safeguards;
• The use of medications, including giving patients their medication and the prescribing of sedatives and antipsychotics;
• Continence and personal care;
• Daily activities;
• Relatives and carers and their involvement in care;
• Culture and leadership.

The spot checks – which were undertaken in 22 of the 51 older people’s mental health wards in Wales between November 20 and December 18, 2014 – revealed areas of good and excellent practice across Wales together with areas which required improvement.

In the main, they found staff who were doing their best to provide good quality care in the face of a number of challenges. Where the team of reviewers discovered and highlighted immediate concerns, these were raised with the health board immediately to take urgent action.

The teams identified variation in practice within and between individual wards in health board areas. However, they did not find a repeat of the serious failings, which have been identified in an independent report about Tawel Fan ward, in Ysbyty Glan Clwyd, North Wales.

A number of key recommendations have emerged from the spot checks, including:

• Ensuring older people have access to daily activities on wards;
• Staff need to feel they can raise concerns easily; have effective training and understand the necessary legal safeguards;
• The need for improvements to ward environments, in particular ensuring simple maintenance tasks and repairs are undertaken promptly;
• Flexible visiting hours should be encouraged on wards.

Professor Drakeford said: “These spot checks have provided us with assurance that poor care and neglect are not systemic features of the care of elderly mental health patients in Wales. They also highlight compassionate care provided by staff.

“However, the report does acknowledge there is room for further improvement. I expect health boards to continue to develop and improve services for older people with mental health problems both in hospitals and in the community.

“To support this and to take forward some of the key findings from the spot checks, I have announced that more than £5m a year will be invested in the NHS to provide psychiatric liaison services at our district general hospitals and ensure that daily activities are available on all older people’s mental health wards. I have also asked Public Health Wales to create an older people’s mental health community of practice so best practice and innovation can be shared across Wales.

“Our NHS is something we can all be proud off, but we are not complacent. When problems are identified we work hard to put them right.”