An under-fire mental health trust has been told that it has improved its services by the CQC – but has still been ordered to reform areas of its care to increase patient safety and better patient outcomes.

Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) has faced widespread criticism for its care – but the latest inspection report from the Care Quality Commission (CQC) has noted that steps forward have been made. 

The trust has vowed to do more going forward, whilst expressing “pride in [our] staff” for spearheading and adapting to changes, and “confidence that improvements will continue”.

But TEWV’s overall rating has not changed, still being rated as “needs improvement”, and although no service has been rated inadequate any longer, the CQC has outlined that “more needs to be done”.

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Problems with the reporting and investigating of serious incidents – which can be examples of omissions in care that result in “avoidable death” – could have prevented important lessons being learned to prevent incidents from recurring.

At the time of inspection, there was a backlog of about 100 serious incident reports yet to be filed. A serious incident, defined under the NHS framework as an “event where the potential for learning is so great or the consequences to patients… so significant that they warrant particular attention to ensure these incidents... trigger actions that will prevent them from happening again”.

TEWV staff outlined that since CQC investigations wrapped up in June, they have tackled the bulk of this issue, with only 10 remaining serious incident reports outstanding.

Read more: 41 patients died in six months following contact with TEWV crisis team

Waitlists remained a large issue too, with patients continuing to “wait too long” to access some services - though there is evidence that this may be a national issue.

Issues noted by independent investigations into the deaths of teenage patients Emily Moore, Christie Harnett and Nadia Sharif found issues with the ability of patients to use ligature points, and staff’s frequent use of restraint in care.

TEWV pled guilty in connection to the deaths of Christie Harnett, and a second young woman, Patient X. The trust is to be tried for the death of Emily Moore early next year.

The trust’s reducing restrictive practice programme for 2022-23 had failed to reduce overall rates of restraint, with rates of restraint in TEWV’s services increasing by 17 per cent since the previous year, though more dangerous forms of restraint – such as supine and prone restraint – had been reduced.

Read more: TEWV knew about crisis team issues months before man's death

But CQC’s deputy director of operations in the North, Sarah Dronsfield, said that “some outstanding practice in wards for older people with mental health problems” had been found by investigators.

Brent Kilmurray, chief executive of the trust, said: “We are at the halfway point of our five-year transformation programme and fully accept that further improvements are needed to get to where we want to be. However, we have come a long way in a relatively short space of time and this report demonstrates our continuous improvement. 

“It’s pleasing that a running theme throughout the report is that our staff are kind and caring and demonstrate our values in the care they provide. The majority of our services are rated as ‘Good’, and elsewhere the CQC recognises that progress is being made.

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“The report also acknowledges that leaders at all levels have ensured that improvements were made since the CQC’s last inspection.

“As with other trusts throughout the NHS, successful staff recruitment remains a pressing priority and is the key to us achieving all our goals.

“I would like thank everyone involved for their dedication and hard work in delivering the positive changes and we are committed to staying focussed, continuous improvement and providing safe and kind care.”