Following the publication of the Care Quality Commission’s (CQC) report into our services the Quality Improvement Services were delighted to see that NELFT received a new overall rating of Good.
The services reviewed the report and were extremely pleased to see focus being given to the importance of further embedding quality improvement throughout the trust.
The services were particularly happy to read the following statements:
Mental health crisis services and health-based places of safety:
- Best practice in treatment and care:
- Staff working for the home treatment teams used recognised rating scales to assess and record severity and outcomes. Staff working for the home treatment teams and in the health-based places of safety participated in clinical audit, benchmarking and quality improvement initiatives.
- Staff took part in clinical audits and benchmarking initiatives. The HBPoS audited its practice in respect of section 136. Staff participated in clinical audits, which helped to assure the quality of the service provided to patients. Staff completed audits on the use and application of the Mental Health Act and ligature risks.
Acute wards for adults of working age and psychiatric intensive care units:
- Use of restrictive interventions:
- Staff made every attempt to avoid using restraint by using de-escalation techniques. Staff restrained patients only when these failed and it was necessary to keep the patient or others safe. Between November 2021 and April 2022 there had been 298 incidents of restraint across all wards. Of these incidents, 85 occurred on Picasso Ward and 78 occurred on Titian Ward. Prone restraint, where a patient is in a face down position, occurred 50 times across all wards. Twenty of these restraints occurred on Titian Ward. Managers said that where a patient may need to be restrained in the prone position initially, staff would move to less restrictive holds as soon as safely possible. Wards were focused on reducing the use of restraint; a quality improvement project was in progress, data was regularly reviewed to look at trends and the reasons for them.
- Learning, continuous improvement and innovation:
- Staff collected and analysed data about outcomes and performance and engaged actively in local and national quality improvement activities. Staff were given the time and support to consider opportunities for improvements and innovation and this led to changes. For example, implementing new technology for dispensing medicines and managing temperatures.
- Monet Ward was part of a well-established quality improvement project, working with a London university and other trusts, to reduced restrictive interventions. All other wards participated in the trusts respect approach, which aimed to reduce restrictive interventions by conducting mutual help meetings, safety huddles, and by monitoring data on restrictive interventions.
- "The trust participated in a range of local and national audits. Staff participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. Audits were carried out on areas of care such as care planning, risk assessments, physical health observations and infection control. Wards peer reviewed each other’s record keeping and shared the outcomes."