THE NHS trust which provides many mental health services in Tameside has been given a warning notice to improve its wards for older people.
After concerns from whistleblowers and people using the service, the Care Quality Commission (CQC) inspected Pennine Care Foundation Trust, which looks after the Hague and Summers Wards, as well as the Whittaker Day Unit at the borough’s hospital and several other parts.
And it has issued the notice to focus its attention on making specific improvements to ensure care was person centred, as well as providing enough staff with the right skills and training to meet people’s needs.
Inspectors visited after ‘concerning information’ about several wards between June and October 2024 was received.
They found care plans did not always show how it was centred on the individual or that the views of carers or relatives had been taken into account.
It was not clear that people who were not detained under the Mental Health Act could leave the wards freely.
People did not always have a clear understanding of their rights.
There was no quality assurance process to check whether compliance with the Mental Health Act was taking place for people.
CQC did find levels of physical restraint and other restrictive practices such as seclusion were low.
However, a report, which gives an overall grading of ‘requires improvement’ – dropping from good – states: “Care plans did not usually show how care was centred on the individual or that their views and the views of their carers and close relatives had been taken into account in a meaningful way.
“The trust’s governance systems, for example records audits, did not always have the capacity to identify shortfalls in people’s care and some areas of care.
“Although the wards were usually staffed to safe levels, we saw a high use of temporary staff to cover vacancies, staff sickness and enhanced clinical need on the wards and the systems for induction and training of temporary staff did not always ensure that staff were familiar with the wards and the needs of the patients they were caring for.
“Some patients told us that the wards could be short-staffed at times, sometimes they were cared for by unfamiliar staff, particularly at night, and that sometimes staff did not have time to chat with them while providing care.
“Some patients told us that they were bored on the wards and that there were not a lot of activities available, however some patients were more positive about the activities available.
“People’s relatives and carers mostly gave us positive feedback. However, told us that visiting times were restricted, with some reporting that they were only allowed an hour with their relative.
“The trust did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that.
“They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.
“The trust did not always share concerns quickly and appropriately.”
After inspecting all nine of the trust’s wards between November 4 and 7, the CQC told it to submit a plan showing what action it is taking in response to these concerns.
This has been provided and the body will continue to monitor it to ensure improvements are made and people are safe while it happens.
Pennine Care NHS Foundation Trust was formed in 2002, has an income of approximately £280 million and employs more than 4,300 staff.
It provides inpatient, community and specialist mental health services across Bury, Heywood, Middleton and Rochdale, Oldham, Tameside and Glossop and Stockport to a total population of 1.3 million people, providing care to more than 70,000 in 2023/24.
It provides 150 different serviced but also dropped from good to requires improvement for how well-led, effective, caring and responsive it is. Being safe has been re-rated as requires improvement.
Alison Chilton, CQC deputy director of operations in the north west, said:
“We found at our inspection of Pennine Care NHS Foundation Trust’s wards for older people with mental health problems, that some of the concerns we had received about the safety and quality of the service were substantiated.
“We would like to thank people using the service, and staff for their bravery in sharing their concerns, as it helped us to have a better picture of the care being provided to people, which determines if we need to take any action to keep people safe, including carrying out an inspection.
“On the wards we found there were times when there wasn’t enough permanent staff, and sometimes people were cared for by staff who weren’t familiar to them, particularly at night.
“Also, staff didn’t always have time to sit down and talk to people and give them the social interaction they need.
“It was also concerning that staff weren’t always trained to provide care to people in a safe way. For example, many staff caring for people with dementia hadn’t received any dementia awareness training.
“However, despite these issues, people and their relatives felt that wards were clean and well maintained which helped to keep them or their loved ones safe.
“We shared our findings with the trust, so they know where improvements are needed, and since the inspection, they have informed us that they have started to make progress on these.
“We will continue to monitor the service closely, including through future inspections, to ensure people are safe.”