Tees, Esk and Wear Valleys NHS Trust told to 'urgently improve' by watchdog

The Care Quality Commission (CQC) has told Tees, Esk and Wear Valleys NHS Foundation Trust to make urgent improvements following inspections which took place from June to August.

The CQC carried out an unannounced inspection of forensic inpatient wards due to concerns around 'unsafe staffing numbers' and 'poor culture within the service'. The watchdog also looked at how well-led the trust is overall.

Short notice announced inspections were also carried out at community mental health services for working age adults, crisis services and health-based places of safety, as well as community child and adolescent mental health services (CAMHS). This was due to concerns raised about the safety and quality of these services.

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Following this inspection, the crisis services and health-based places of safety had improved and is now rated good, previously it was rated requires improvement.

The overall rating for the trust remains as requires improvement. Community CAMHS also remains rated as requires improvement and community mental health services for working age adults has gone down from good to requires improvement. The forensic inpatient wards have dropped from good to inadequate.

Inspectors found that 'there were not always enough staff in some services who knew patients well enough to keep them safe. In some services this impacted on the safety and quality of care and meant that staff were not always meeting the needs of patients' and 'there were high waiting times in community mental health services for children and young people. There was a lack of oversight of the waiting list management process and risks to children and young people were not reviewed'.

However, inspectors said 'the board had approved further workforce investment for inpatient services and there was an ongoing recruitment process in response to staffing challenges' and 'the trust had taken action in response to enforcement action following an inspection of acute and psychiatric intensive care wards. As a result, simplified and introduced more effective systems to assess and manage patient risks within inpatient services'.

In response to the report, trust chief executive Brent Kilmurray said: “We fully accept that there remains much work to be done and we are already taking the steps necessary to address the issues highlighted in this report.

“The common factor in most of the issues raised by the CQC is staffing pressures. Easing this pressure is our biggest challenge and we are working extremely hard to resolve this. There is an NHS-wide staff shortage, and the problem is particularly acute in this region. This comes at a time when demand for our services is particularly high and we have invested in recruitment for a range of vacancies and new roles to meet demand.

“The pandemic has meant that staff absences due to sickness have been at an all-time high over the last 18 months. It is against this backdrop that our staff are striving to deliver the best possible care.

“Our crisis teams – the first port of call for those in urgent need – have performed particularly well to improve their ratings to Good in really difficult circumstances.

“That said, we apologise unreservedly for the instances where the high standards we set ourselves have not always been delivered. We are determined to change for the better.

“We are taking the culture issues extremely seriously and have put new management arrangements in place to address this, putting our values of respect, compassion and responsibility at the heart of everything we do, all aimed at making this a great place to work.

“In the meantime, we will work with the CQC to positively ensure that their requirements are met.”

Stockton North MP Alex Cunningham said: “Patients, family members and staff all deserve to know that the facilities provided by the Trust are fit for purpose and working in the best interests of those using the service.

"This recent inspection and rating of parts of the service as “requires improvement” and “inadequate” shows there is still a long way to go before TEWV is providing a safe and secure environment for patients and staff.  

“It’s clear that positive changes are being made and the Trust is making progress. At the same time however it faces tremendous challenges and needs robust and practical support to improve further.

"With a high vacancy rate there is a real need for an increase in staffing. The Government has a role to play here in ensuring enough health professionals are trained to allow our health services to provide the best quality.

"Despite repeated calls however the Government is yet to explain what meaningful intervention it will make to build up staffing levels and make sure the Trust succeeds.

“I’ll be meeting with the Chief Executive of the Trust next week and will press him on what measures he intends to put in place to ensure the Trust improve and service users are looked after in a safe environment."

Alex Cunningham, MP for Stockton North, said: "Patients, family members and staff all deserve to know that the facilities provided by the Trust are fit for purpose and working in the best interests of those using the service. This recent inspection and rating of parts of the service as “requires improvement” and “inadequate” shows there is still a long way to go before TEWV is providing a safe and secure environment for patients and staff.  

“It’s clear that positive changes are being made and the Trust is making progress. At the same time however it faces tremendous challenges and needs robust and practical support to improve further.

"With a high vacancy rate there is a real need for an increase in staffing. The Government has a role to play here in ensuring enough health professionals are trained to allow our health services to provide the best quality.

"Despite repeated calls however the Government is yet to explain what meaningful intervention it will make to build up staffing levels and make sure the Trust succeeds.

“I’ll be meeting with the Chief Executive of the Trust next week and will press him on what measures he intends to put in place to ensure the Trust improve and service users are looked after in a safe environment.”

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