Nottingham attacks: ‘Ongoing concerns’ at mental health trust that cared for triple killer
The health watchdog has found “ongoing concerns” with the quality of care at the mental health trust that treated Nottingham killer Valdo Calocane.
The Care Quality Commission (CQC) said that Nottinghamshire Healthcare NHS Foundation Trust must improve “to protect patients, families, and the public from the risk of harm”.
Health Secretary Victoria Atkins called for a rapid review of the trust in January after Calocane was sentenced to a hospital order for killing Grace O’Malley-Kumar, Barnaby Webber and Ian Coates in Nottingham last year.
Two parts of the review have been published – an assessment of patient safety at the trust and an assessment of progress made at Rampton high-security hospital.
A third part of the view – on Calocane’s care from the trust – will be published in the summer.
It said that over the last five years, it has raised “ongoing concerns about the quality of community and inpatient mental health services at NHFT and has taken enforcement action including restricting admissions to Rampton Hospital”.The review into patient safety and quality of care at the trust found:
People struggled to access the care they needed when they needed it, “putting themselves and potentially members of the public, at risk of harm”.
The quality of care and treatment across the trust “varied” and “care provided did not always meet the needs of individuals”.
High demand for services and staffing shortages meant that patients were not always being kept safe.
Action to address safety concerns was often “reactive”.
On Rampton Hospital – the high-security facility which has been inspected by the CQC five times between 2019 and 2023 – inspectors raised concerns about a number of issues, including: “pockets of poor culture”, poor communication between staff and patients, particularly for those in long-term segregation; and concerns over staffing levels.Inspectors said the hospital should be given a 12-month licence, rather than the usual five-year licence period “to allow for improvements”.
Chris Dzikiti, CQC’s Director of Mental Health, said: “While we found some improvements, our review of Nottinghamshire Healthcare NHS Foundation Trust highlights ongoing concerns around people’s care and safety. We have set out clear recommendations for action the trust needs to take so that services provide safe care and treatment, and to protect patients, families, and the public from the risk of harm.
"The concerns around demand for services and access to care, staffing and leadership at NHFT must be addressed - NHS England will be supporting improvement and we will be working with them closely on this.
"However, the findings of our review must also be a starting point to look more closely at the gaps in community mental health services so that real improvements can be made nationally to quality of care, patient safety and public safety.”
In response to the CQC findings, Nottinghamshire Healthcare NHS Trust said it's "truly sorry" that "sometimes we have let down patients and families", and that it has made improvements to staff and safety.
Ifti Majid, Chief Executive, Nottinghamshire Healthcare said: “We are committed to providing high quality, effective and safe care to those people who need it most, and that is why this report makes difficult reading because it is clear that sometimes we have let down patients and their families and for this, we are truly sorry.
“External inspections are an important way of helping us learn and make the improvements that are needed. We didn’t wait for the special review or the report to begin making our improvements to staff and safety and developing much more of a learning culture across our services.
“These improvements included:
* Successful recruitment campaigns have made significant gains in nursing, including recruiting more than 75 nurses and healthcare assistants to work at Rampton since the summer, with 20 more joining us very soon; at Highbury Hospital we have zero healthcare assistant vacancies. * Every single one of the people waiting to be seen in our services has been risk assessed and a crisis plan agreed with them so that they know who to contact if they become more unwell. * Therapeutic observations have been a common theme throughout our improvements, and we have now audited more than 1,100 therapeutic observations and these demonstrate that in 97% of instances observations are now working well. * Reviewed our crisis line offer in its entirety and secured an upgraded telephony system which will support a reduction in the number of unanswered calls. * Deployed more senior nursing leaders into our inpatient services, strengthening the way that clinical and operational leaders work together across our services. * Transitioning at pace to the national Patient Safety Incident Reporting Framework (PSIRF) which is already enabling greater learning and improvement.“We deliver care and treatment to tens of thousands of people at any one time and the vast majority of our 10,000 colleagues are providing care in a kind and compassionate way, often in challenging circumstances.
“We welcome the additional support that we are now receiving as part of the national Recovery Support Programme, including the support of our improvement director. We are currently developing our integrated improvement plan and we will ensure that every recommendation within the CQC’s rapid review report is implemented so that those who use our services receive the high quality care they deserve."
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