A copy of the CQC Inspection report is attached for members’ information.
The Committee received a presentation by P Scott, Managing Director Tees Esk and Wear Valleys NHS Foundation Trust and S Gill, General Manager for Adult Learning Disability Services which provided members with information on the CQC report into Adult Learning Disabilities inpatient services across Durham Tees Valley and a plan for improvement work (for copy see file of minutes).
The Adult Learning Disabilities inpatient services are provided from two sites in Durham Tees Valley which are Bankfields Court in Middlesbrough and Lanchester Road Hospital in Durham. The service is commissioned to provide assessment or medical treatment for persons detained under the Mental Health Act 1983 treatment of disease, disorder, or injury. The presentation summarised the CQC report and the findings and also described the improvement journey since the inspection along with the next steps for the service.
Co-opted member R Gott advised that she had previously worked in mental health and that a significant part of the training was focussed on observation. Considering this, she expressed concern regarding the inconsistency of staff and that some may not recognise the trigger symptoms patients displayed. She emphasised the good work the service was doing but, in her opinion, if staff were not consistent, she could not see how the service could improve. The General Manager stated that these were critical points and that consistent staff had been fundamental for past success of the service and advised that agency staff had not been used until the COVID-19 pandemic. The Managing Director clarified that when agency staff were required, the service endeavoured to use the same staff to ensure consistency with patients. The General Manager noted the challenges with staff retention due to the difficult nature of the roles and that alternative jobs for similar salaries were available and were not as challenging but stressed that focus of the service was always on the quality of care. Co-opted member R Gott believed that continuity of staff avoided psychiatric emergencies.
Councillor Stubbs highlighted the outcome of the previous CQC report in 2019 had been good and questioned how the service had become inadequate in the short space of time. He noted the control measures that had been put in place and asked if these would enable the service to recognise any future issues early. The Managing Director confirmed that the service had learned a great deal from the recent inspection and had a clearer understanding of the quality of the care patients were receiving daily and advised that the Fundamental Standards Group also met three times per week to review standards. The General Manager confirmed that the outcome of the inspection had provided a good framework to engage with staff and to help staff understand the expectation of the service.
Councillor Howey asked whether any assurances could be given that the service would not be in this position again. She also suggested that staff salaries be increased as if agency staff were required, they would come at a higher cost, and higher paid salaries could help with staff retention. The General Manager commented that retaining the workforce continued to be a priority and that different options were currently being considered in the recruitment strategy. In response to a further question from Councillor Howey, the General Manager advised that it was important for staff to have a voice and stated that the service held staff engagement sessions.
The Managing Director emphasised that the CQC Inspection Report did not reflect what Members would see if they visited the sites at Bankfields Court and Lanchester Road hospital and the General Manager advised that all Members were welcome to visit the sites.
Councillor Earley asked if there could be a future item on the agenda to update the Committee on the progress of recovery. The Chair confirmed that the item would come back to the Committee so that an update on progress could be provided.
That a further agenda item is scheduled for the Adults, Wellbeing and Health Overview and Scrutiny Committee to provide members with an update on the progress of the Adult Learning Disabilities inpatient services across Durham Tees Valley.