England's Chief Inspector of Hospitals has rated Greater Manchester Mental Health NHS Foundation Trust as Good following an inspection by the Care Quality Commission. This inspection included child and adolescent mental health wards and wards for older people which had previously been rated as requires improvement.
CQC also inspected acute wards for adults of working age and psychiatric intensive care units; long stay/rehabilitation mental health wards for working age adults and substance misuse services. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
The service was rated as Requires Improvement for safety, Good for caring, effectiveness and responsiveness and Outstanding for well-led. As a result of this inspection, the trust’s overall rating remains unchanged as Good.
Paul Lelliott, Deputy Chief Inspector for hospitals and lead for mental health:
“Greater Manchester Mental Health NHS Foundation Trust was formed a year ago when two NHS trusts combined. It was clear to our inspectors that the leadership team had successfully overseen the acquisition of a number of poorly performing services and were managing to maintain a strong performance.
“We found that the relationships with stakeholders for Manchester services, including staff, unions, commissioners had improved. There was a strong commitment to provide the best care for all patients across the service.
“However - there are areas for improvement. We have made it clear that the trust needs to focus further on safety. In acute wards for working age adults and psychiatric intensive care units, staff were not following the trust’s policy in relation to rapid tranquilisation and in child and adolescent mental health wards, checks to ensure that equipment was safe to use had not always been carried out.
“Inspectors said staff dealt with patients with commitment, energy and patience. Staff were proud to work for the organisation. Leaders were visible and approachable and understood the challenges facing the trust.
“The inspectors found that although there were vacancies and sickness, the trust’s systems to manage this ensured there were sufficient staff. Some training courses were below the trust target, but the trust had taken steps to ensure there were enough skilled staff to provide care. Medicines were managed safely. Risks related to the two electronic management systems were being managed.”
Care plans were not always personalised in acute wards for working age adults and psychiatric intensive care units, but otherwise care plans were holisitic and patient centred. While the rights of people who were detained were protected, there were issues with forms of authorisation and requests for second opinion doctors in wards for older people.
Feedback from people using the service was positive, with patients and carers reporting that staff were supportive and kind. People were generally involved in planning their care although this was not always the case in acute wards for adults of working age and psychiatric intensive care units. Substance misuse services received the highest proportion of compliments from patients.
The inspection team found some outstanding areas of practice. In substance misuse services the rapid access to the alcohol pathway provided by the Chapman Barker Unit was an innovative and effective service. The service accepted referrals from accident and emergency services across Greater Manchester and provided rapid access to specialist detoxification as an alternative to hospital admission.
The trust had established a building recovery in communities asset fund. This was used to support a range of recovery orientated groups and projects including allotments, training cafes, theatre groups and gym access.
Bev Humphrey, Chief Executive of Greater Manchester Mental Health said, “It has been just over 12 months since we acquired Manchester Mental Health and Social Care and we embarked on ambitious transformation plans. To be rated as ‘Good’ at such an early stage is remarkable. Our staff have undergone significant change which can be unsettling and worrying, nevertheless, it is clear from the report that service users and carers feel supported and that our staff are energetic and committed to them.
“We are so pleased that our efforts to improve relationships in Manchester have been recognised and that we are working hard to bring the high standards of care to Manchester, which we have in the other districts we serve.
“We are also incredibly proud that our substance misuse services were rated as ‘OUTSTANDING’. We pride ourselves on being trailblazers in this field and the innovative work we do in this area has a real impact on people’s lives.
“Leadership throughout the last year has been vital, in order to help staff with new ways of working and the coming together as one organisation. For this to have been rated as ‘OUTSTANDING’ is a tremendous endorsement for the ways in which we achieved this, which has been a culmination of collaboration, learning and devising shared values which become the cornerstone of how we treat our service users, carers and each other.
“We are aware there is still much work to do and areas where we need to continue to improve. However, there can be no better indication that after 12 months of hard work, we are united as one organisation working to deliver our vision of improving lives.”
CQC will return to inspect the trust at a later date to check on whether further progress has been made.
Gr8 to know that @GMMH_NHS had ‘Good’ CQC rating in the recent inspection. Still exciting 2 learn that we had ‘Outstanding’ rating for Well-Led. Wat a Gr8 achievement. Recognition 4 excellent leadership & hardworking passionate frontline staff. Thank you all #Proud #Energising pic.twitter.com/9yy0zM89sC— Coumar(Coumarassamy) (@davidcoumar) 23 February 2018
A great career, a great organisation, delivering great care. https://t.co/jtU0xbpAmm— Paul French (@pfrench123) 23 February 2018
Well done to @GMMH_NHS on your good rating from @CareQualityComm. Inspectors found a strong commitment to provide the best care for all patients and feedback from people using the service was positive, with patients and carers reporting that staff were supportive and kind. https://t.co/qPBKBCI0dO— GMHSC Partnership (@GM_HSC) 23 February 2018
Well done GM Mental Health Trust @GMMH_NHS, rated ‘good’ by @CareQualityComm with ‘outstanding’ leadership, just a year after taking over failing Manchester MHT. #devodifference https://t.co/tNWbSL8VgB— Jon Rouse (@JonRouseGM) February 27, 2018
Full details of the ratings, including a ratings grid, are given in the report published online at: http://www.cqc.org.uk/provider/RXV