Norfolk and Suffolk NHS Foundation Trust rated 'inadequate' for third time in four years by Care Quality Commission
Mental health services in Suffolk and Norfolk have been rated 'inadequate' for the third time in four years.
Norfolk and Suffolk NHS Foundation Trust (NSFT) remains in special measures after the Care Quality Commission listed a catalogue of failings - with some 'significant' concerns raised in 2014 'not yet fully addressed'.
Health bosses and watchdogs say they are 'extremely concerned' by the findings with major reviews in the pipeline for the region's mental health services.
The trust, which runs services such as Wedgwood House in Bury St Edmunds, says it has been taking action to address the 'immediate concerns' raised and acknowledged it needed to 'resolve ongoing issues' but such 'wide-scale transformation will take time'.
Problems highlighted in the CQC report include:
Widespread low morale across services, which was attributed to a 'do unto' attitude staff felt came from senior management and directors.
Too many referrals were handed off inappropriately or refused and downgraded from urgent to routine without due care.
Many instances of people who had significant needs who were denied a service.
Records showed that some patients had harmed themselves while waiting for contact from clinical staff.
Not all wards were safe and fit for purpose.
There were not enough nursing and medical staff in all services to keep people safe from avoidable harm.
Vacancies remained high particularly for nursing and medical staff.
However, inspectors noted that staff treated patients with 'compassion and kindness', they respected patients’ privacy and dignity, and supported their individual needs.
They also found that the trust has 'committed to improving services by learning from when things went well and when they went wrong, and has begun to promote training, research and innovation'.
The trust was rated 'inadequate' in 2014 and was taken out of special measures in 2016 but this was re-imposed after being judged 'inadequate' again last year.
Ed Garratt and Frank Sims, chief officers for the clinical commissioning groups in Norfolk and Suffolk, said: "We are extremely concerned that despite the efforts of many dedicated, hardworking members of staff, NSFT remains in special measures.
"The welfare of patients is of the utmost importance and fundamental changes need to be made to ensure they are safe and receive the best possible care.
"As a system it is imperative that we redouble our efforts to support NSFT’s staff, whose care and commitment has been acknowledged in the CQC report, to deliver those changes."
They said they have worked with partners to develop a mental health strategy for Suffolk, which will go before the Suffolk CCGs' governing bodies for approval in January.
Andy Yacoub, chief executive of Healthwatch Suffolk, said the strategy has been shaped by the views of service users, carers and professionals.
He added: "“In our opinion, this is the only way forward for the people of Suffolk, be they a service user, carer or professional.
"A strategy for the county that is not built around the NSFT but instead around the views and experiences of people using the services and those who support them."
Two major reviews of mental health services in Norfolk are expected to report back in the new year.
Antek Lejk, chief executive of NSFT, said: "We are obviously disappointed with the CQC's findings, but fully accept their report and its recommendations.
"Although we have been working hard to make improvements, we recognise that the actions we have taken so far have not resulted in the rapid progress which both the CQC and our trust had hoped for.
"Since receiving the draft report, we have been taking action to address the immediate concerns found by the CQC and listening to our staff and service users to make sure we fully understand the deeper challenges faced by the trust.
"This will allow our new senior management team to make long-term, sustainable changes which are based on their knowledge and experience and also draw on best practice from across the wider NHS. We are determined to get things right.
"We need to ensure consistent good practice across the trust and bring all of our services up to the standard our patients and carers deserve. Our priorities now will be to resolve ongoing issues around access to services, waiting lists, care planning and staffing levels, while also making sure we have the right systems in place to ensure patient safety at all times.
"Such wide-scale transformation will take time and will not always be smooth, but we remain committed to making the necessary changes in the right way so that we can ensure our services provide safe, effective care for everyone in Norfolk and Suffolk."
NSFT's Board will discuss the report in public at its meeting at the Athenaeum in Bury St Edmunds on Thursday, November 29, running between 12.30pm and 3.30pm.