The CQC inspection at four sites run by North London NHS Foundation Trust was prompted in part following a number of deaths and serious incidents

Mental health wards run by a local NHS trust at four North London sites have been urged to improve by the Care Quality Commission (CQC).

CQC inspected the mental health sites for working age adults and psychiatric intensive care units (PICUs) spread across Enfield, Haringey, Barnet and Camden boroughs and all run by North London NHS Foundation Trust (NLFT).

The inspections in February and March this year included mental health wards at Chase Farm Hospital in Enfield, St Ann’s Hospital in Tottenham, Edgware Community Hospital, and Highgate West Mental Health Centre.

The sites were all brought under the responsibility of NLFT – a new organisation formed from the merger of Barnet, Enfield and Haringey Mental Health NHS Trust and Camden and Islington NHS Foundation Trust – late last year.

The merger prompted CQC to arrange fresh inspections last spring and the health watchdog has today (Thursday 24^th) published a report in which it rates the NLFT sites as ‘requires improvement’.

The mental health wards for working age adults and PICU were previously rated ‘good’ at both trusts – before the merger – in February 2022 and January 2023 respectively.

The CQC inspection was also prompted in part to follow up on a number of deaths and serious incidents, both when they were run by separate trusts and following the creation of NLFT, to see if improvements had been made.

Under the safe, effective and well-led inspection categories, the mental health sites have all been rated ‘requires improvement’, while under the caring and responsive category . However, they’ve been rated ‘good’ under the caring and responsive categories.

Jane Ray, CQC deputy director of operations in London, said: “When we inspected these wards, we were concerned to find the trust didn’t always provide care that was safe or personalised to people’s needs.

“We found that whilst there had been some lessons learnt from serious incidents, there was more to do. For example, staff weren’t always carrying out observations safely or checking on people regularly while they were in seclusion, despite additional training, which could place people at serious risk of harm.

“Some safeguarding incidents also hadn’t been reported, including incidents of assaults between people in the service. This meant there was a risk of these incidents not being addressed appropriately.

“Some people said that at times they didn’t feel there were enough staff and this made them feel unsafe, particularly at night, when there could be delays in receiving support. Whilst there were bank staff available, there were still some unfilled shifts which could impact on people’s care.

“We also found some inappropriate blanket restrictions in place. On some wards people did not have access to hot or cold drinks and snacks without asking staff.

“Staff didn’t always monitor people’s physical health well enough, and inspectors saw one incident in which staff failed to administer insulin to a person with diabetes.

“We’ve told the trust where improvements are needed, and leaders have begun work on an action plan to address our concerns. We’ll continue to monitor these services closely, including through further inspections, to ensure these improvements are made quickly and people receive safe care while this happens.”

Inspectors also found some people waiting a long time for beds, staff feeling pressured by management to discharge people they felt weren’t ready, and staff giving some people medications that weren’t included on their consent forms.

However, staff reported that they understood how to respect people’s rights under the Mental Health Act, were passionate about quality improvement projects the trust was running, and felt that managers were accessible and that they could raise concerns about people’s care when needed.

Asked to respond to the findings, a NLFT spokesperson decided to focus mainly on the positives and said: “As a newly formed trust, NLFT has done a great deal of work since its formal establishment in November 2024 to ensure that the very best aspects of our predecessor organisations and component services are used as the benchmark for the quality of care, safety and experience of our patients and their families. Our community deserves nothing less than the very best.

“I’m pleased to see that today’s report confirms we have prioritised important aspects relating to safety of the services we provide, including ensuring staff can identify and report any issues of concern, and that we hold safety huddles, and have robust reviews of all reported incidents.

“We know we have further to go but I am confident that we are in a good place to move forward further and faster with this vital work.”

They added: “The formal inspections undertaken by CQC and other bodies are an important part of how we measure progress in our continual improvement, and I’m grateful to the inspection team and all the staff, patients, families and carers who made time to share feedback and information about the progress we’re making in our journey towards creating better mental health, better lives and better communities.”

Read the full CQC report:
Visit cqc.org.uk/provider/G6V2S/inspection-summary#Acute-wards-for-adults-of-working-age-and-psychiatric-intensive-care-units

No news is bad news

Independent news outlets like ours – reporting for the community without rich backers – are under threat of closure, turning British towns into news deserts.

The audiences they serve know less, understand less, and can do less.

If our coverage has helped you understand our community a little bit better, please consider supporting us with a monthly, yearly or one-off donation.

Choose the news. Don’t lose the news.

Monthly direct debit

Annual direct debit

£5 per month supporters get a digital copy of each month’s paper before anyone else, £10 per month supporters get a digital copy of each month’s paper before anyone else and a print copy posted to them each month. £50 annual supporters get a digital copy of each month's paper before anyone else. £84 annual supporters get a print copy by post and a digital copy of each month's before anyone else.