THE mental health service’s ability to adequately care for, protect and ensure patients’ well-being has been thrown into question by inspectors who warned chiefs to take “significant steps to improve.”

Following an inspection in June, health watchdog the Care Quality Commission found that while staff were caring, Avon and Wiltshire Mental Health Partnership was falling short of basic responsibilities and, in some cases, placing patients at unnecessary risk.

A team of 70 people, including doctors, nurses, hospital managers, trained members of the public and CQC inspectors spent four days at the trust’s 39 wards and 27 community services in Swindon and across Bristol, Wiltshire, Bath and North Somerset, meeting patients and staff.

The inspectors had a number of concerns about safety, particularly on the mental health admission wards and forensic mental health wards.

These problems were made worse by staff shortages that inspectors said may have affected patients’ care and safety.

While they acknowledged that staff at Swindon’s Applewood ward in Sandalwood Court were for the most part dedicated and caring, they raised fears about insufficient staff numbers.

“Staffing levels and skill mix were set and reviewed, however we were told that the staffing levels were not always sufficient on Applewood ward,” inspectors said.

“Staff and patients told us this was leading to high levels of patient stress.”

Out-of-hours and intensive services were poor, as was the support given to patients moving back to primary care.

“Some people told us they received an inconsistent and not always caring response,” inspectors said.

“Some people also said they could not always speak with someone when they needed to outside of office hours.

“They said calls were not always returned, or only returned several hours after they had made contact.

An independent survey of 56 Swindon patients presented to the watchdog also put a question mark over the adequacy of care.

People who completed the survey were generally unhappy with the level of care they received, particularly with the standard of care, support and access to the intensive service.

CQC identified 32 areas where the trust should improve.

But inspectors were complimentary about Swindon’s psychiatric liaison service and its close working partnership with the Great Western Hospital.

Dr Paul Lelliott, the deputy chief inspector of hospitals, said: “Avon and Wiltshire Mental Health Partnership has room for improvement in many areas.

“Many thousands of people depend on its services.

“We found staff treating patients with respect and communicating with them effectively. Frontline staff showed they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments.

“We had a number of concerns about safety – including unsafe ward environments that did not promote the dignity of patients, insufficient staffing levels to safely meet patient’s needs and inadequate arrangements for medication management.

“Some of these were known to the trust before our inspection – so it is a matter of concern that these issues have still not been addressed.

“I recognise that there has been a change in the most senior leadership of the trust, which has now embarked on a programme of service improvement.

“The onus is on them now to make the urgent improvements we require – and then to sustain that improvement in the long term.

“We will continue to monitor their progress – and take further action if that is required.”

Action already well under way

DESPITE inspectors’ concerns, AWP chiefs were positive improvement could be made and were already happening in Swindon.

AWP chief executive Iain Tulley said: “Significant changes have happened over the last couple of years and we remain absolutely committed to these improvements continuing.

“It’s important we recognise the uniqueness of Swindon’s needs. It’s about improving the service for local people.

“The trust is committed to improve quality and work with commissioners to get the best with the resources afforded us.

“I want to assure the public we recognise where we have deficiencies and where it has impacted people. As the report points out, we have inadequacies and we will address them.

“I welcome the fact we can do it with our commissioners and we will crack this together in both Wiltshire and Swindon.”

They also welcomed inspectors’ praise of staff’s care and dedication to patients.

AWP’s clinical director for the Swindon locality, Simon Manchip, said: “Our only major recommendation was looking at medicine storage in a couple of departments and we have addressed that. Staff levels are a problem for all psychiatric services across the UK; relatively, Swindon is not doing too badly.

“But we want to improve that. We have rolling recruitment programmes. We are going to be looking not just at having the same number of staff on the wards but the right number of staff that patients need at that time.

“Patients and families know there is a lot of pressure on the usage of beds and that’s something we are aware of. We are working with the Clinical Commissioning Group to move this forward. We welcome the CQC’s report. There were few unknowns. These were issues that both as a provider and a commissioner we were aware of and working together on. It’s not going to be easy but we have the desire to work on them.”