Children and young people with mental ill health ‘slipped through the net’ as staff were forced to make own waiting lists

Diane Hull, chief nurse at Norfolk and Suffolk Foundation Trust (NSFT). Photo: NSFT

Diane Hull, chief nurse at Norfolk and Suffolk Foundation Trust (NSFT). Photo: NSFT - Credit: NSFT

Staff working in children and young people's mental health were forced to make their own waiting lists as official data was so inaccurate and cases 'slipped through the net'.

Those were the findings of a report into services provided by the region's mental health trust when inspectors visited in April.

In the Care Quality Commission (CQC) report into Norfolk and Suffolk Foundation Trust's (NSFT) specialist community mental health services for children and young people, inspectors said some things had improved but there had not been enough progress.

NSFT chief nurse Diane Hull said: "We acknowledge there is a significant amount of work to be carried out."

The report found:

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- Staff had "overlooked some patients on the waiting lists and had not followed them up"

- "Waiting list data [...] was not always accurate and staff in some services had created their own waiting lists to be assured that information was being captured correctly"

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- In one case staff assumed another agency had made a safeguarding referral about a patient but this was not true and it had not happened

- Record keeping was poor, staff did not always update risk assessments and there was "limited evidence of detailed crisis plans"

Poor record keeping was raised by senior coroner for Norfolk Jacqueline Lake in a report released last week into the death of 15-year-old Ellie Long, from Wymondham.

The anorexic teenager had been under the care of NSFT at the time of her death and Mrs Lake said records were either not recorded properly, handwritten notes were not uploaded onto the electronic system, and some notes only came to light during the inquest into Miss Long's death.

She said: "Record keeping has been raised elsewhere as a matter of concern within NSFT. I have concern that full record keeping and disclosure requirements will not remain a priority."

CQC inspectors found staff "felt positive about recent changes to key leadership posts and that they were starting to see the impact of these".

And Ms Hull said: "The improvements that the inspectors found around culture are encouraging because without them, the changes we need to make to quality and safety will be more difficult to achieve."

She added the trust was keen to build on the sense of cautious optimism which many staff reported to the CQC inspectors

But "many of the care records were written poorly" - just 10 out of the 47 reviewed by inspectors were deemed up to scratch.

Inspectors had to flag up eight specific cases where they found there had not been any recent contact with patients, causing concern they had been forgotten.

The trust admitted three patients had "slipped through the net" and some patients had been waiting nearly a year to be seen.

Ms Hull said: "The report highlights issues that we were already aware of and are working hard to address, but it will help us to quicken the pace of improvement in our community mental health services for children and young people.

"With the help and support of our staff and the involvement of service users and carers, we are determined to make improvements, not only to the services inspected in April but to all of our services at all locations."

Problems recruiting

Inspectors also found there had been issues with recruitment, and the report said: "The youth teams all had problems recruiting."

There had been a recruitment campaign in Norfolk, with some posts filled, but Suffolk was not included and a separate business plan was needed.

This was approved during the inspection.

What does the service need to do?

Inspectors said NSFT needed to make sure there was effective leadership in place and systems needed to be reviewed in risk management, recruitment, and making sure risk assessments were in place.

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