Agenda item

(a)CQC Inspection results and improvement plans

(b)TEWV COVID 19 Pandemic Update – Durham and Darlington Locality Mental Health Services

The Committee received a report presented by Jennifer Illingworth, Director of Operations, Durham and Darlington TEWV NHS Foundation Trust which provided an overview of the Trust’s response to the COVID-19 pandemic. 

The report also included an update on the CQC action plan developed in response to the Trust CQC Inspection undertaken from September to November 2019 (published in March 2020) (for copy see file of minutes). 

Referring to the response to the COVID-19 pandemic, the Director of Operations confirmed the Trust has seen an increase of patients admitted into mental health beds who had not previously been community service users.  Investigation work is being undertaken as a result of this, with case studies being developed in order to gain a better understanding.  A mental health support telephone line has been opened up for those with lower level mental health needs to alleviate the pressure on the Crisis service.  Future demand planning work is being carried out in order to predict mental health needs in the forthcoming years which includes the needs of those who have been affected, whether directly or indirectly, by COVID-19.  A particular focus for support throughout the pandemic has been care homes including those for people with mental health and learning disabilities, to provide targeted support to those individuals who have required it, and, to provide additional psychological support to staff during this challenging time.

Councillor Temple referred to the term, ‘moral injury’, which is described in the report as ‘frontline and essential workers may have come across difficult situations in the pandemic and be troubled by their own, or others’ actions that they feel go against good practice’, and he asked if an example could be provided to illustrate this. The Head of Adult Services explained that adult services staff are trained to support those suffering from trauma and assist people in crisis.  As a consequence, they themselves develop coping mechanisms, however, COVID-19 had led to a different dynamic, with staff being more likely to be professionally compromised.  For example, prior to COVID-19, it would have been in the best interests for a client who lacked capacity to have a face-to-face consultation, together with their family in attendance, for support.  During the pandemic, it has been necessary to conduct this work remotely, leading to clients and their families having a different experience.  This may cause a sense of burden on the professional who could feel frustrated that they are not able to perform their duties in the way they would like.  Councillor Temple thanked officers for the useful, personal perspective. 

Councillor Crathorne spoke of the invaluable support provided through the voluntary sector during the pandemic. The Director of Operations agreed and added that moving towards increased joint working with the community and voluntary sector had been a very positive aspect of the pandemic. 

The Principal Overview and Scrutiny Officer explained the background for the Committee’s request for information on the CQC inspection results was, at the time the request was made, there had been media coverage relating to issues such as the Crisis Service and the Child and Adolescent Mental Health Service, which had prompted CQC inspections. 

The Director of Operations explained that the overall rating had reduced from ‘good’ to ‘requires improvement’ and the two domains requiring improvement were identified as safety and responsive. The safety domain includes environments and buildings, and, at the time of the inspection, older estate buildings were located in North Yorkshire and York, however, a new hospital had now opened in York which had alleviated some of the CQC’s concerns.  An Action Plan was being developed in response to the CQC Inspection.

The Director of Operations agreed to bring a further report to a future meeting of the Committee, with a specific focus on actions for the Durham area.

The Chair thanked the Operations Manager for the update.

Resolved:

a)   that the CQC Inspection results and Improvement Plans be noted;

b)   that the TEWV COVID 19 Pandemic Update be noted.