CQC finds some improvement in Cambridgeshire mental health service, but more is needed

The Care Quality Commission (CQC) has rated a service run by Cambridgeshire and Peterborough NHS Foundation Trust requires improvement.

CQC inspected the trust’s acute wards for adults of working age and psychiatric intensive care in October. Two wards, Mulberry 1 and 2, are at Fulbourn Hospital, and three wards are at the Cavell Centre, Peterborough.

Publication of the CQC report follows the leaking of a highly critical Culture Review last week in which a variety of concerns were raised by staff at the Cavell Centre including alleged bullying, racism and discrimination.

The inspection was undertaken to assess whether improvements had been made after an inspection of Mulberry 2, in May, uncovered issues which led to CQC serving the trust a warning notice. The previous inspection was prompted by an allegation of sexual assault on Mulberry 2.

In addition to rating the trust’s acute wards for adults of working age and psychiatric intensive care units requires improvement following the latest inspection, CQC rated the service requires improvement for being safe and well-led. Inspectors assessed whether the service was caring, but they did not issue a rating as this was a focused inspection to consider specific concerns.

Before the publication of this latest report, the service was rated good.

Ratings for the trust are unchanged by this inspection. It remains good overall.

Similarly, no new ratings were issued for Fulbourn Hospital or the Cavell Centre.

“We recognise there is still work to do but I am so very proud of the dedication of our staff.”

Anna Hills, Chief Executive of Cambridgeshire and Peterborough NHS Foundation Trust, said: “I am pleased the CQC has acknowledged the improvements that have already taken place and everyone at the Trust is committed to ensuring that progress continues across our services.

“We recognise there is still work to do but I am so very proud of the dedication of our staff. The Trust’s overall ‘good’ rating is a tribute to them.

“The impact of Covid and the demand on services remains hugely challenging but our colleagues continue to put patients at the very centre of everything they do.”

“The trust is well-placed to continue its improvements"

Craig Howarth, CQC head of hospital inspection, said: “The trust has made some welcome improvements on Mulberry 2 at Fulbourn Hospital, particularly regarding patient observations and staff training, in response the issues we identified following our previous inspection. This means we can remove the warning notice we previously served.

“However, the trust must ensure improvements it has made at Fulbourn Hospital are replicated at the Cavell Centre to consistently provide care and treatment that ensures people’s safety.

“This includes ensuring observations are undertaken in line with best practice, despite limitations posed by staffing shortages. To monitor this, the trust must ensure observation records are fully completed.

“The trust is well-placed to continue its improvements in the service as staff morale was good, and it was actively recruiting to address its staffing shortage.

“We have reported our findings to the trust so it can build on what it’s getting right and address what needs improvement.

“We continue to monitor the service, hospital and trust – including through future inspections – to support the safe and effective care and treatment people have a right to expect.”

What the inspection found

The inspection found:

The trust hadn’t applied all lessons learned from Mulberry 1 and 2 at Fulbourn Hospital to the Cavell Centre wards.

On the three wards inspected at the Cavell Centre, staff could not always observe bedroom corridors, and patients told inspectors that patients of the opposite gender sometimes entered the bedroom corridor.

Staff didn’t always complete daily cleanliness checklists at the Cavell Centre.

Records didn’t always show which staff member had completed observations or searches.

However:

The trust had improved patient observations on Mulberry 2. Although observations hadn’t always taken place on the ward due to staff shortages, CQC was assured new CCTV and swipe access cards reduced the risk of patients entering other patients’ bedrooms.

Staff on Mulberry 2 had completed enhanced observations training, and the trust planned to deliver this across the other wards. Observation records had improved since the previous inspection.

The trust’s oversight of sexual safety at Mulberry 1 and 2 had improved. The trust had also introduced a sexual safety project, which it co-produced with patients, and it was delivering sexual safety training to all staff on the wards.

Wards and patient bedrooms were all clean and tidy. Staff supported patients who had additional needs regarding the cleanliness of their bedroom, and they checked bedrooms regularly.

The trust had completed audits, including for observation records and infection prevention and control.

Staff told inspectors they felt supported by managers and morale was good within teams, despite staff shortages. The trust was actively recruiting to vacant roles.

Wards held regular governance meetings and had monitored progress against the action plan to meet the warning notice requirements.

The report will be published on CQC’s website on Friday 9 December.