Issue - meetings

18.1     The Committee considered a report by the Assistant Chief Executive summarising the recent CQC Report on Sussex Partnership NHS Foundation Trust (SPFT) services and SPFTs Action Plan developed in response to the report.

18.2     In addition to the report by Colm Donaghy, Chief Executive of SPFT, the following points were made in response to Members’ questions:

·        SPFT was in the process of developing its Strategic Plan at the time of the CQC inspection in January 2015. The CQC recognised that the Plan was in development, but indicated that they would comment on the current situation and so reported that SPFT “lacked strategic direction” at the time of the inspection.

·        Wards for People with Learning Disabilities were rated as inadequate for effectiveness because of the performance of the 11-bed Seldon Centre in Worthing. The CQC noted in their inspection that the way that staff were treating patients at the Centre was causing risk. SPFT has now carried out the necessary training to address staff practices and the Centre has improved as a result. The Centre does not require capital investment in order to improve.

·        Long Stay/Rehabilitation Mental Health Wards for Working Age Adults were rated inadequate on safety grounds because of one facility: Hanover Crescent in Brighton, which is now closed. Hanover Crescent was a community rehabilitation facility where patients were stepped down in preparation for community living. SPFT procured the facility several years ago and safety regulations have been tightened in the intervening period. Consequently, the facility was deemed to have had too many ligature points to be deemed safe, although there had not been any serious incidents at the facility. SPFT could not put this right without major capital investment, so the decision was made to close the facility.

·        Wards for Older People with Mental Health Problems were rated inadequate on safety grounds primarily due to dementia inpatient beds in East Sussex. SPFT has proposals in place to ensure that the two inpatient facilities are centralised, which is due to take place soon. This reconfiguration will require capital investment.

·        SPFT is currently hiring three Non-Executive Directors. This is not because of CQC recommendations to replace the Non-Executive Board, but because three current Non-Executive Directors have left simultaneously for different reasons:

o   one Non-Executive’s term of service is up, so their role is being advertised;

o   one has been appointed to a senior post elsewhere and cannot commit to the workload;

o   the third has resigned due to ill health.

·        SPFT is carrying out a Governance Review to ensure governance arrangements in the organisation work as effectively and as efficiently as possible. Monitor requires foundation trusts to review their governance each year, but this review has additional motivation:

o   the CQC report identified the SPFT did not deal with risk as well as it should;

o   the new Chief Executive considered the governance process to be slightly unwieldy.

·        In cooperation with the Grassroots, SPFT has produced a suicide prevention app called StayAlive that provides information to users about  ...  view the full minutes text for item 18

A report on the recent CQC report on SPFT services.

9.1       Neil Waterhouse, Sussex Partnership NHS Foundation Trust (SPFT) Service Director for East Sussex, attended for this item.

9.2       The committee discussed how best to scrutinise the recent Care Quality Commission (CQC) inspection report of SPFT services and SPFT’s Quality Improvement Plan in response to the report. It was agreed that the initial work in this respect should be undertaken via the informal joint committee of Sussex HOSCS. Cllrs Ensor and Wincott are the East Sussex HOSC representatives on this committee.

9.3       Committee members were invited to suggest areas of concern for the joint committee to focus on. Areas suggested were:

·         Standards of ward-based care

·         Bed availability - for both adult mental health and Children & Adolescent Mental Health Services (CAMHS)

·         Services for people with Learning Disabilities (LD)

·         Data on in-patient admissions, length of stay, discharge and re-admission rates (concerns that financial pressures mean that it is too hard to access in-patient beds, that patients are discharged too early, and that re-admission rates may be higher than they should be)

·         Suicide prevention (both in terms of strategic planning for the population of Sussex and in terms of managing in-patient risk at SPFT units)

·         Access to CAMHS

9.4       Mr Waterhouse told the committee that it is crucial that mental health receives the same parity of esteem as physical health, and that there have been positive recent developments towards this goal. In terms of the CQC report, the inspectors identified many areas of good practice across the trust, but also some areas of concern. It was particularly disappointing that aspects of services for the most vulnerable people were found to be unsafe.

9.5       Recent changes to the management of SPFT mean that services are increasingly delivered on a ‘locality’ basis. However, the CQC did not report separately on services in East Sussex, West Sussex and Brighton & Hove and it is difficult to use the report information to determine how each locality is performing, although it is evident that performance across Sussex is variable. For example, the use of out of area beds has been a problem for the trust in some localities, but not a significant issue in terms of East Sussex.

9.6       Mr Waterhouse noted that there had been a good deal of recent work to enhance CAMHS provision. For example partners have focused on improving services for young people detained for assessment by the police (under section 136 of the Mental Health Act), so that there is no inappropriate use of policy custody suites. This is in line with the recently agreed Crisis Care Concordat.

9.7       Mr Waterhouse told members that SPFT would be happy to talk about trend data, noting that East Sussex services performed well in terms of re-admission rates.

9.8       With regard to suicide prevention, the HOSC Chair, Cllr Ensor, wished to record his thanks to all agencies involved in this work, particularly the Beachy Head chaplaincy service, coastguard and ambulance services, and the Samaritans. The Chair specifically wanted to commend the work of Cllr Beryl Healey, who  ...  view the full minutes text for item 9