A Care Quality Commission report published in October 2017 found areas requiring improvement in South London & Maudsley NHS Foundation Trust’s community based mental health services. This report provides a brief update on the improvement plan that has been put in place and provides assurance that services are improving for Croydon residents.
The Panel were informed that the community mental health services in Croydon provided by SLAMwere reviewed by the CQC in 2017 with the overall rating being that the service required improvement. Following the CQC findings and the Woodley Review key areas of improvement had been identified and an improvement plan developed. SLaM had identified changes that needed be made and there was a strategy to build a borough approach that would develop local service and drive improvement. Furthermore a service borough Director had been recruited and was due to start on 1 April 2018.
Officers informed Members the service had experienced large increases in activity within the last 12 months and it was a challenge to balance the growth in demand. Referrals had doubled in the last four years from 50 a month to around 100.
The Panel were informed that there was an increasing focus towards early intervention and there was work ongoing to refocus resources to support this work.
Members were informed that SLaM were due to present at the Health & Social Care Scrutiny Sub-Committee in March 2018 a more in depth report on their response to the CQC report and Woodley Review, and their action plans. Members requested that they be invited to this meeting.
The CCG had conducted a review in January 2018 following the CQC inspection and while the report was not yet available early findings were that improvements had been made and that frontline staff were working hard to resolve issues. Additional staff had been appointed however further work remained to ensure improvements were realised.
Members noted that high levels of sickness and vacant posts were identified by the CQC and queried what processes were in place to resolve these issues. Officers stated the council had recruited new staff, including newly qualified social workers, and were training them to enable them to undertake more senior roles. A good training programme was also being developed for AMPs. It was recognised that there difficulties were being experienced by SLaM to recruit mental health nurses and so, where appropriate, some posts were being advertised to social workers also.
Officers noted that CCG commissioners had in the past stopped funding services without consulting the Council, however it was felt that the relationship with the CCG was improving and there was a growing appetite within the CCG to improve mental health services and the importance of prevention and early intervention. Furthermore, it was felt that the One Croydon Alliance could be used as vehicle to drive further improvements in the future with Mind having a similar role to Age UK within the over 65 model.
Members raised concerns regarding the CCG decision to cut community services which were working to help residents to not have to present for acute care. It was noted that cutting these services was increasing the volume of care required which cost more money. Officers stated the Council had looked to mitigate the impact by reviewing whether it could assist the services by assisting with grant applications and some providers had been successful and continued to provide community support.
The Chair noted that more funding was needed within mental health and informed Members that a joint letter had been sent to all the MPs within Lambeth, Southwark, Lewisham and Croydon raising concerns regarding funding; in particular that Croydon was one of the lowest funded boroughs in London.
Officers stated that once the new director at SLaM had started on 1 April 2018 it was hoped that the issue of monitoring the audits would be resolved as they were looking to get an agreement to regularly review the audit reports to ensure progress was being made.
In response to Member questions officers stated that no beds had been closed within the acute wards but work was being undertaken to reduce the length of stays and to prevent patients returning to hospital.