CQC raises rating of acute wards at Cross Lane hospital in Scarborough but still say they 'require improvement'

Following an unannounced inspection of acute wards for adults of working age and psychiatric intensive care unit services at Tees, Esk and Wear Valleys NHS Foundation Trust in January, the CQC gave an inadequate rating and served the trust a section 29A warning notice.

A follow up inspection took place on 25-27 May of nine of the trust's wards including Esk ward at Cross Lane, a 13 bed female acute admission ward which treats patients whose mental health problems cannot be treated and supported safely or effectively at home.

Inspectors were looking at whether the service was safe and well led and if improvements had been made to address the concerns identified earlier in the year including systems to assess and mitigate patient risk on the wards.

The report reads: "We found that the trust had made improvements in the areas in the section 29A warning notice to the extent that we no longer had serious concerns about systemic failings relating to the governance arrangement around the management of patient risks."

Improvements have been sufficient enough for the section 29A notice to be removed.

When looking at whether the service was safe, the inspectors gave a rating of 'requires improvement' as "we have identified a breach of a regulation and issued a requirement notice."

For the question of whether it is well-led, the inspectors also gave a rating of 'requires improvement' because "although the trust had better systems in place to comprehensively assess and mitigate patient risk on the wards, these had not been fully embedded yet."

The inspection report states that patient risks were still not always fully reflected in the files inspectors looked at; staff had not always flagged current incidents; and were not always mitigating the risks of operating mixed sex accommodation to fully promote patients' safety.

However, the report does say the trust now has better systems in place and effective procedures and staff had better understanding when it came to risk assessment.

Staff were found to not always be following the trust's policy and expectations and the report specifically referenced leaders at Cross Lane who were using a paper file system for safety briefing reports which didn't include all recent reports and staff were unaware of the intranet version.

In response Brent Kilmurray, Chief Executive at Tees, Esk and Wear Valleys NHS Foundation Trust, said: "We no longer use paper versions of safety briefing reports to prevent any duplications or errors.

"Each ward now operates all safety briefing discussions and reports by using visual control boards."

Inspectors also raised concerns about an issue relating to sexual safety on Esk ward at Cross Lane.

The report states one female bedroom looked out to an area not within the fence boundary of the female side but on the male side.

The glass was frosted but the window opened slightly which could compromise patient privacy and dignity.

Mr Kilmurray said: "We are part of a national sexual safety collaborative and we take this feedback very seriously.

"We have carried out work on the environmental issue relating to the female bedroom and have put up additional fencing so that patient privacy is maintained."

In response to the report and new rating he added: "Whilst we are pleased that the improvements have been recognised, this is just one step on a longer journey to change.

“Our staff have worked tremendously hard to provide a safer, more caring, and compassionate environment for everyone involved with us.

"We have received great support from our health and care partners. I want to thank everyone who has been involved and has supported us.

“However, we know that there is still work to do and we are committed to continually improving the experience for people in our care, their families and carers and our staff.

"Over the coming months we’ll continue to implement our new strategy and embed our values in everything we do.”