CQC upgrades children and young people’s mental health services at Tees, Esk and Wear Valleys NHS Trust

The Care Quality Commission (CQC) has upgraded specialist community mental health services for children and young people at Tees, Esk and Wear Valleys NHS Foundation Trust from Requires Improvement to Good.

CQC carried out an inspection in April to assess improvements made since its previous inspection. The services provide specialist community mental health support to children and young people up to the age of 18 across the trust.

Following the latest inspection, the overall service has been rated Good, with the effective, well-led, caring and responsive areas all receiving Good ratings. However, safety remains rated Requires Improvement.

The overall rating for Tees, Esk and Wear Valleys NHS Foundation Trust also remains Requires Improvement.

Inspectors found improvements across the service and reported that staff regularly went above and beyond to ensure children and young people received a good level of care.

During appointments observed by inspectors, staff demonstrated kind and compassionate approaches. Young people reported feeling seen and heard by staff and said they felt safe opening up to them.

Relatives and carers also reported being treated with warmth, understanding and patience, while some said their children looked forward to appointments.

CQC found continuity of care was being maintained when young people moved between services or transitioned into adult mental health services.

Waiting lists remained high but were below the national comparison. Staff were also using tools to identify when a young person’s level of risk was increasing and take action.

Improvements had been made to how quickly young people were seen, with referrals reaching teams considered best suited to their needs and those with more complex needs able to receive support more quickly.

The trust operates Getting Help teams, Getting More Help teams and a Children and Adolescent Mental Health Services Crisis Team, which work closely together to direct young people to services appropriate to their needs and level of risk.

Inspectors found safety incidents were managed well and investigated thoroughly to identify learning and improvements.

Staff understood how to protect young people from abuse and worked effectively with other agencies, while clinicians demonstrated a good understanding of the Mental Health Act and Mental Capacity Act.

Managers were found to be supportive of staff, and leaders used feedback to make improvements to services based on the needs of local communities.

However, CQC identified further improvements needed around young people’s risk assessments.

Some of the assessments examined by inspectors did not include plans explaining how identified risks should be managed or what contingency arrangements were in place to keep young people safe.

Some staff also reported that pressures within the service were having a negative impact on their wellbeing, although inspectors found this was not affecting the care provided to young people.

CQC will continue to monitor the trust to assess whether improvements in the quality of care are embedded and sustained.

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