Adult mental health services rated good, but improvements still needed

Mental health services for adults in Devon have been rated as 'good' overall, but inspectors found some staff were 'stressed, exhausted and burnt out' due to the pressures of the Covid pandemic.

The Care Quality Commission (CQC) has published its inspection report on services provided by the Devon Partnership NHS Trust.

Inspectors visited the trust's acute wards for adults of working age, psychiatric intensive care unit (PICU), community services for adults of working age and forensic inpatient and secure wards.

They found good care was being provided, with some areas being rated better than before, but the trust has been told to make improvements in the forensic inpatient and secure wards, where staff morale was very low.

However, the inspectors also found examples of outstanding care. They highlighted the Cofton ward at Langdon Hospital, Dawlish, which is one of three locations countrywide taking part in a pilot programme on sexual safety.

Improvements in leadership and staff training

Karen Bennett-Wilson, the CQC's head of hospital inspection for mental health, said:

"When inspectors visited Devon Partnership NHS Trust, they were pleased to see that most areas had improved despite the significant pressures caused by the pandemic which is good news for people using these services.

"Since our last inspection, there has been several changes to the leadership team, including a new chair and non-executive directors. The executive team has been strengthened and now has a wide range of skills and high level of awareness of the priorities and challenges facing the trust and how to address these.

"We saw clear improvements in the way the community mental health teams for adults of working age monitored patients on waiting lists to keep them safe and responded to any changing risks.

"Improvements had also been made to the safety of the environment in the acute wards and psychiatric intensive care unit. The trust had introduced simulation training in ligature risk management with over 100 staff now trained in this area. Cameras had also been installed in blind spots on wards to enable staff to safely observe patients. This meant the premises were safer for patients and staff knew how to identify any potential risk areas.

What changes need to be made?

Karen Bennett-Wilson added: "There are, however, areas where improvements must be made and maintained. In the forensic inpatient and secure wards, morale was very low with staff feeling stressed, exhausted and burnt out following the demands of the pandemic. Before the inspection, CQC received whistleblowing concerns from staff who felt their views were not listened to or welcomed. The service had a high number of nursing vacancies which added to the pressure of existing staff. In addition, care plans in this area were inconsistently completed and did not reflect the patient's involvement.

"We have reported our findings to the trust and are pleased that the strong commitment from all at the trust to deliver good services has resulted in higher standards of care for people across most areas. The provider must now ensure these changes are sustained and the necessary improvements are made in the areas we have highlighted."

The full report can be seen on the Care Quality Commission's website.