The Care Quality Commission found a breach of a safety regulation relating to risk assessments within CAMHS at Tees, Esk and Wear Valley NHS Foundation Trust
CAMHS at Tees, Esk and Wear Valleys NHS Foundation Trust was inspected in April(Image: Dominic Lipinski/PA Wire)
Services for young people at a mental health trust have improved, a regulator has found, but concerns remain over safety.
The Care Quality Commission (CQC) has upgraded its rating for child and adolescent mental health services (CAMHS) at Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) from “requires improvement” to “good”. The latest inspection, carried out in April, found the service is performing well and meeting expectations.
However, a breach of a safety regulation was identified. This had been highlighted in the previous inspection in 2002 but the CQC has found it has not “sufficiently improved.”
The CQC looked at services including Teesside CAMHS Crisis and Intensive Home Treatment, the Tees Valley Getting Help team and the Teesside Neurodevelopmental Assessment team. The concern relates to risk assessments and planning.
The report said a review of 25 care records showed that not all risk assessments were “fully comprehensive” or included safety summary planning. Inspectors said the issues were more evident within the Crisis and Intensive Home Treatment Team and Getting More Help teams.
Jayne Reid, CQC deputy director of mental health in the North East, said: “Inspectors looked at some that didn’t include plans to manage risks or what the contingency plans were to keep them safe.” The trust will be asked to provide an action plan in relation to the breach.
In response, the chief nurse at the trust has said they will take action “and continue to focus on learning, improvement and providing safe, kind and person-centred care.”
The other four areas inspected – effectiveness, leadership, care and responsiveness – were rated as “good”. Inspectors found:
The service managed safety incidents well and carried out thorough investigations to identify any learning and improvements.Staff understood how to protect young people from abuse and the service worked well with other agencies to do so.Clinicians had a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA) meaning they could support people well.Managers were supportive of staff and valued their teams and the work they were doing.Leaders used feedback to make improvements to services to meet the needs of people in their local communities.The trust had Getting Help teams, Getting More Help teams and a CAMHS Crisis Team which were closely interlinked to ensure young people were directed to the most appropriate service to meet their needs and level of risk.
Ms Reid said: “At this inspection, we were encouraged to see improvements across the service, and we saw staff regularly going above and beyond to ensure children and young people were receiving a good level of care. A theme throughout the inspection was young people telling us they felt seen and heard by staff and felt safe to open up to them.
“It was positive to hear relatives and carers say that they were met with warmth, understanding and patience by staff and that their loved ones looked forward to their appointments. Leaders ensured there was continuity of care when young people moved between different services or into adult mental health services.”
She said waiting lists remained high but less when compared nationally and staff used tools to identify and take action if a young person’s risk was escalating. She added: “Leaders and staff should feel proud of the changes they’ve made and the positive impact these changes have had on young people using services.
“We’ve shared our findings with leaders, so they know what improvements need to be made to keep people safe and we’ll continue to monitor the trust to ensure the quality of care is embedded and sustained.”
Beverley Murphy, chief nurse at the trust, said they recognises the area that still requires improvement. “The report is clear that we must strengthen the consistency of risk assessments, safety summaries and safety plans,” she said.
“We will take action on this and continue to focus on learning, improvement and providing safe, kind and person-centred care.”
Regarding the improvements noted by the CQC, she said: “This report shows the determination of our colleagues to improve care for young people across our communities. We’re incredibly proud of our CAMHS service and, most importantly, the dedicated staff who make a positive difference every day.
“We’re pleased that the service has been rated good overall, with inspectors recognising caring, compassionate and committed staff, positive feedback from young people and carers, and improvements in staffing, responsiveness and how teams work together. It also demonstrates the positive changes we’ve made since our last inspection in 2022, when this service was rated as requires improvement.
“Alongside our partners we’ve improved access to care so young people can get help more quickly, closer to home and in ways that support them to thrive in their families and communities.” The full report will be published on the CQC website in the coming days.
The overall rating for TEWV remains as “requires improvement”. In December last year, then-Health Secretary Wes Streeting announced that a statutory public inquiry into mental health services at the trust would be held. However, Teesside Live reported earlier this month how the inquiry was still without a chair.
The organisation has come under intense scrutiny in recent years over its management of cases including the deaths of three teenage girls in 2019 and 2020. It was previously reported that the three teenagers – who took their own lives – were each failed, with 119 shortcomings within the NHS and social care identified.
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