North London mental health trust rated ‘requires improvement’

The Care Quality Commission (CQC) has rated a north London mental health and community trust as ‘requires improvement’ overall following an inspection but found that a number of its services are better than the last visit.

Barnet, Enfield and Haringey Mental Health NHS Trust was rated ‘good’ for being caring, responsive and well-led, and ‘requires improvement’ for being safe and effective.

Inspectors found that staff found it hard to keep patients safe and protect their privacy and dignity because some of the trust’s buildings were old and did not provide a good environment for patient care.

Patients who need access to seclusion rooms sometimes had to be moved through public areas and had to use bathrooms that contained potential ligature anchor points.

However, the trust had improved many ward environments since the last inspection and had proposals to rebuild St Ann’s hospital, but it needed to continue work to improve all environments.

Staff in the acute wards for adults of working age and psychiatric intensive care units did not complete physical health checks for patients following rapid tranquillisation.

The trust still needed to embed improvements in physical health monitoring and planning, specially in community services for adults with mental health needs.

Staff did not always receive regular formal supervision. In some teams managers did not record when staff completed formal supervision or what had been discussed.

However, of the 12 separate mental health and community health services managed by the trust, two are now rated ‘outstanding’: forensic inpatient/secure wards and community-based mental health services for older people.

Paul Lelliott, CQC’s deputy chief inspector and lead for mental health, said: “Whilst the trust is still rated as Requires Improvement it is now close to achieving a rating of Good in the future.

“We carried out a full review of the trust’s leadership and governance processes and found it was well-led and had made many improvements since our last comprehensive inspection.

“Most staff felt proud to work for the trust and were committed to ensuring they delivered good care for patients. Most staff supported patients with kindness and respect.”