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South London and Maudsley NHS Foundation Trust rated good but inspectors warn that acute care is ‘inadequate’

South London and Maudsley NHS Foundation Trust has been rated ‘good’ by the Care Quality Commission’s latest report, but inspectors warn that acute care is ‘inadequate’ in the face of high demand and ‘breaches of fundamental standards of care’.

Overall the NHS Trust, which includes the Denmark Hill-based Maudsley hospital and Bethlem Royal Hospital in Beckenham, was awarded a ‘good’ rating in the report published on October 23.

The inspection was held from July 2 to August 16 of this year, with inspectors saying staff treated patients and carers with ‘kindness and compassion’ and involved them in decisions about their care and treatment.

There were significant improvements since its last inspection in 2015, with areas of both ‘good’ and ‘outstanding’ work.

But in terms of safety, the trust still ‘requires improvement’ and its acute adult wards are now classed as ‘inadequate’.

The report summarised: “There had been breaches of fundamental standards of care on the acute inpatient wards, which had not been appropriately escalated to senior leaders in the trust.

“The flow of patients into and out of the acute care pathway was poor. Bed occupancy was above 100 per cent on most of the acute wards. There was not always a bed available for someone who needed one. Some patients were sleeping on couches or in seclusion rooms rather than in a bed. This was unsafe and compromised the dignity of the patients.

“In the previous year there were over 30 incidents of this happening.

“Governance systems had not identified this unacceptable practice, or a few other serious shortfalls such as staff not always carrying out physical health checks on patients after they were administered intra-muscular rapid tranquilisation.This put patients at risk of avoidable harm.”

The trust’s chief executive Dr Matthew Patrick said: “An overall good rating reflects the care and compassion of our staff who do their best every day, often in difficult circumstances, to improve the mental health of our service users.

“Quality is our number one priority and we are working constantly to improve our care.

“We regard the CQC’s findings as a further opportunity to make positive change and we have submitted comprehensive improvement plans to them regarding the action we are taking as a result of this report.”


How each service is rated

  • Specialist eating disorders – good
  • Community mental health services – outstanding
  • Long stay rehabilitation mental health wards for working age adults – good
  • Wards for people with a learning disability or autism – outstanding
  • Acute wards for adults of working age and psychiatric intensive care units – inadequate
  • Child and adolescent mental health wards – good
  • Community-based mental health services for adults of working age – requires improvement
  • Community-based mental health services for older people – good
  • Forensic inpatient/ secure wards – good
  • Mental health crisis services and health-based places of safety – good
  • Neuropsychiatry services – good
  • Specialist community mental health services for children and young people – good
  • Wards for older people with mental health problems – good


How each area is rated

  • Safe – Requires improvement
  • Effective – good
  • Caring – good
  • Responsive – good
  • Well-led – good


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