Sheffield’s medical care trust rated ‘requires improvement’ after a year of ‘inadequate’

The Care Quality Commission (CQC) has published a 98-page report on Thursday following inspections at Sheffield Health and Social Care NHS Foundation Trust in May where they visited the acute wards and psychiatric intensive care units, mental health wards for older people, and crisis and health-based places of safety which were previously rated inadequate.

At this inspection, the CQC rated two services as requires improvement but the acute wards and psychiatric intensive care units remain as inadequate as further improvement was required with a warning notice issued to the trust.

It was also rated requires improvement for being safe, responsive, effective and well-led.

Despite concerns raised in these areas, the trust receives an overall rating of requires improvement with a rating of good for being caring. The trust was rated inadequate overall in 2020.

Forensic wards or community-based mental health services for adults of working age were not part of this report as they were already rated requires improvement at the commission’s last inspection but progress of improvements to these services will be closely monitored.

The trust has now been put into Segment 4 of NHS England and Improvement's Systems Oversight Framework where it will receive a package of support through the national Recovery Support Programme, a move the trust said could help ensure the sustainability of the progress.

Brian Cranna, CQC's head of hospital inspection for mental health said: "At this inspection, we were pleased to see that the trust had made some improvements since the last inspection, and so the overall rating has improved from inadequate to requires improvement, although more improvements are needed to keep people safe.

"During this inspection, we remained concerned about the environments on the acute wards. The wards were not well maintained, they contained blind spots and not all risks had been appropriately managed to reduce the risk of people harming themselves.

"We were pleased that the trust had plans to renovate these wards to improve safety.

"We found that not all wards had enough staff who knew patients well and were able to care for them safely. A significant number of agency staff were also not trained in the trust's restraint techniques.

"It was however reassuring to see staff providing, in most services, kind and compassionate care. People who used the services told us that staff were good listeners and provided good care."

The commission said since their last visit, the trust has also made changes to its leadership team, who are aware of the areas of concern and have acted upon these to reduce risk by having a number of revised strategies and improvement plans in place.

"We will continue to monitor the trust, to ensure more changes are made and embedded in order to keep people safe and receive the care and treatment they deserve," he added.

The report said actions the trust must make to improve include ensuring that effective, embedded and sustainable governance and risk management processes are in place to assess, monitor and improve the quality of services and ensuring that the statutory and delegated safeguarding functions are carried out effectively and robust reporting, governance processes and oversight is in place.

The trust also needs to ensure that incidents and safeguarding issues are reported and investigated in line with the trust’s processes and national guidance and that complaints are responded to in a timely manner via a process accessible to patients and staff and that they are used for processes of feedback and learning.

The commission also advised the trust to ensure that there are improvements in the timely completion of serious incident reports and that there is improved governance and oversight of practices and policies in place for monitoring the Mental Health Act.

Welcoming the good news, the trust’s Chief Executive, Jan Ditheridge said the rating was “a real testament” to the staff and managers who have worked hard to put these improvements in place amid the pandemic.

She said: “We wouldn’t have made the improvements that we have made and gone this far without their effort. But we are under no illusion that we still have a lot more to do but this is pointing in the right direction.”

She also said the trust has worked closely with the commission throughout the year so they continued to be on the right track with the improvements, especially involving the acute wards.

"‘We also have more work to do to keep recruiting experienced staff to support our teams,” she said.

She added: “Our teams have shown commitment and determination to make things better for people in Sheffield with wide-ranging improvements, and we’ve done it while meeting the challenges that Covid-19 brought. We know that this acknowledgement of improvement will continue to motivate all of us to keep improving and get back to ‘Good’.

“We have lots more work to do to ensure that service users in Sheffield get the very best care from our Trust. We will be continuing our programme of work to improve our services; our aim has always been to get back to an overall rating of ‘Good’ and that’s what we are aiming for.”

Sheffield Health and Social Care NHS Foundation Trust made headlines in June after one of its units that looks after patients with autism or learning disabilities received damning feedback from the inspectors

amid allegations of failing at the unit.

Acknowledging this, Jan said: “We recognised that we had a problem in that particular unit and we are working very hard to turn it around.”