Mental health services for adults and those in crisis have made "significant improvements" but further work is needed, according to inspectors.

The Care Quality Commission (CQC) inspected Norfolk and Suffolk Foundation Trust's acute wards and psychiatric intensive care units and mental health crisis services in November.

The inspections were in response to potential risks to patient safety, and to review progress following an inspection in October 2019.

In January 2020, NSFT moved from the lowest possible rating of inadequate to requires improvement but remains in special measures.

Stuart Dunn, CQC head of hospital inspection for mental and community health services, said issues raised across the services included not always managing risk well, staff shortages, and patients waiting too long for assessments.

Mr Dunn said: “I welcome the improvements that have been made in the services that we assessed, but the trust has further work to do to ensure that these services meet standards that people should be able to expect."

In its inspection of the acute wards and psychiatric intensive care units for working-aged adults, inspectors kept the service as "requires improvement".

The report said staff did not always manage restricted items well, with four incidents in three months in relation to a prohibited item resulting in self-harm. Staff had intervened before serious harm occurred.

The service did not always have enough nursing staff, with 63 incidents of short-staffing in a four month period.

The CQC report acknowledged the pandemic's impact on recruitment and found staff knew how to protect people from abuse.

The report said there had been very few outbreaks of Covid-19 and when it happened, it was dealt with "effectively".

The trust's mental health crisis service was also rated requires improvement.

The report found the service did not follow systems and processes to safely prescribe, administer, record and store medicines and governance systems were not effective.

Mr Dunn said: "However, we saw a number of areas of improvement and new good practice – and it is clear the trust and members of its staff are working hard to maintain progress."

Since the inspection in October 2019, the trust has launched its first response service, a 24/7 helpline for people of all ages in Norfolk and Suffolk. Staff told inspectors the level of calls were "not manageable" and they could not answer in a timely manner.

Diane Hull, chief nurse at NSFT said: “We’re pleased the CQC recognised the efforts of our hardworking staff and recognised improvements in several areas, including the positive steps being taken by our crisis teams to support our local hospitals’ emergency departments, and how our partnership working is ensuring people receive the right help when they experience a mental health crisis.

“We also recognise the challenges in the report and have put actions in place to address the CQC’sconcerns, including increasing staffing in our First Response service, recruiting staff to specifically support a reduction of self-harm, and we will soon opening an additional 20 beds for older adults in Norwich.”