Mental health trust requires improvement - report

The trust was given a rating of 'requires improvement' by the Care Quality Commission

A mental health trust has been told it requires improvement, following an inspection by the Care Quality Commission (CQC).

Inspectors visited the Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) over three days in July 2024, after concerns were raised about the quality of care being offered.

The report found that the trust had breached legal regulations relating to safeguarding and that staff feared "retribution" for speaking out.

Dominic Hardisty, AWP chief executive, said: "Whilst disappointed with the outcome of the Well-Led inspection, we are pleased to have been rated good in our adult community services and adult wards, which is a tribute to the hard work of our staff."

He added: "This demonstrates a commitment to, and track record of progress, and over the last year we implemented a range of additional improvements in those areas identified by CQC to further enhance the experience for our patients, staff and stakeholders."

'Well-led' inspections focus on ensuring the need for an "inclusive and positive culture" and do not cover the CQC's other areas of oversight such as safety and effectiveness.

The trust provides mental health services in Bath and North East Somerset, Bristol, North Somerset, South Gloucestershire, Swindon and Wiltshire.

Staff 'feared speaking up'

The report stated that the trust had "not ensured, Freedom to Speak Up (FTSU) processes were effective, that racism and discrimination were addressed across all services and safeguarding systems and processes were effective".

It indicated that while staff were aware of the FTSU process, it found that they "feared retribution when speaking up", with some staff reporting that they "did not feel safe in completing staff surveys".

Inspectors also found that certain staff believed there was a "performative culture", in relation to the trust's Equality, Diversity and Inclusion (EDI) ambitions "where senior leaders spoke of inclusion, but there was a lack of action on how the trust truly achieved this".

This was compounded by the finding that "staff felt their career progression and opportunities could be compromised if they disclosed information about their protected characteristics".

'Driving improvements'

The report praised the trust's Green Plan, saying there was a "clear understanding" of where reduction in emissions could be achieved. The trust had also secured grants for solar panels and LED lights.

The trust was also said to have a willingness to "improve culture and hear from patients" and some staff told inspectors that they felt senior leaders were "capable, compassionate and took feedback on board".

Shane Devlin, chief executive officer of NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board, said he was "assured by the progress AWP has already started to make and are committed, as system partners, to supporting its leadership team in driving continued improvements".