Changes at Telford hospital after inspection of mental health services for young patients

The Care Quality Commission issued a six-point notice including orders to devise a system for keeping track of young patients’ location and train staff who handle them after inspectors visited the Princess Royal Hospital.

In a report for the Shrewsbury and Telford Hospital NHS Trust board, Nursing Director Hayley Flavell says the England-wide regulator also issued a two-part warning notice.

This criticised the hospital for not offering patients aged 16 and 17 a choice between a child or adult ward and not “taking into account patients’ needs and preferences” when devising care plans for eating disorder sufferers.

Mrs Flavell notes that all eight points have either been addressed or are subject to an action plan.

In the report, which will be discussed by the board on Thursday, April 8, she said: “The CQC undertook an unannounced focussed inspection of the Children and Young People services at the PRH on February 24 because they had received information about the safety and quality of the provision of the assessment and treatment of children and young people who presented to the service with acute mental health needs and/or learning disabilities.”

The “Section 31” notice – issued to prevent further harm – came two days later.

This notice ordered SaTH to review the records of all acute mental health inpatients under 18 and not admit any more unless they had associated physical health needs.

Ms Flavell said the trust complied with both instructions immediately.

Mrs Flavell notes that the CQC also said: “The registered provider must adopt an effective system to enable them to identify where all patients under 18 are located within the hospital. This must include continuous oversight by a registered mental health nurse and regular oversight from a child and adolescent psychiatrist.”

She says the trust has worked with other organisations, including the Midlands Partnership Foundation Trust, to address this.

She adds that the CQC also ordered SaTH to implement safeguarding systems and train all staff working with under-18s with mental health needs or disabilities to ensure they were “appropriately competent” to do so.

Ms Flavell notes that the trust also received a “Section 29a” notice, complaining that “the service was not inclusive and it did not always take account of children, young people and their families’ individual needs and preferences”.

CQC guidance says Section 29a notices are issued in cases where “significant improvements” are needed and, if not complied with, enforcement action can follow.

Ms Flavell writes that the notice – which SaTH received on March 12 – referred to “choice for 16 to 17-year-olds in relation to them being admitted to the Children’s Ward”.

She says this has already been rectified, and a new operating procedure gives patients that age a choice of an adult of children’s ward.

She also says the warning was a reference to “care plans and food choices for children and young people with eating disorders in particular”.

“The trust is currently developing a standard operating procedure for children with an eating disorder in conjunction with the specialist service provided by the Mental Health Trust [the MPFT],” Ms Flavell writes.

“They are also reviewing all paperwork to ensure these are individualised and allow choice of food and a documentation bundle.”