Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) provided mental health services to people across Cambridgeshire and Peterborough. This inspection on two days in August 2012 was specifically to review the services being provided to people living in the community in the area around Cambridge and south Cambridgeshire. These services were provided from various offices around the area by a number of community mental health teams. Each team provided a specialist service based on people’s needs.

On 9 August 2012, the inspection team looked at the records kept by five of the community teams, and spoke with some of the staff. On 21 August 2012, we invited people who used the trust’s community services, and family carers of people who used the services, to share their experiences with us, at a venue away from the trust’s premises. Approximately 26 people and family carers came to see us and a number of other people contacted us by telephone or email. We also arranged for groups of staff from these services to meet with us on that day, and in total spoke with approximately 50 staff.

Most of the people we spoke with, or who contacted us, were very positive about the service they had received. They praised the support they had been given by a number of the community teams. One person said they felt, “The trust is beginning turning a corner for the better” and, “It makes me feel better”. Another person told us they did not have a bad word to say about their treatment. A third person said, “If it wasn’t for them I wouldn’t be here today”.

People were also very positive about the way they were treated by staff, and the respect they were shown. Comments they made included, “They listen carefully to me, my health is fully discussed and my values are respected”; “They are completely respectful to me”; and, “They give me 100% control of my illness”.

The majority of care records we looked at were personalised and well written, and included a thorough assessment of each person’s needs, treatment plans, goals and risk management strategies. However, in one team, two of the five care plans we looked at did not contain sufficient information about the ways in which each person’s needs would be met and a third person’s care plan had not been put in place in a timely manner to ensure their needs were met.

Most of the people we spoke with were satisfied with the cooperation they had encountered between the trust and other agencies that could help them. People felt they had been given adequate information about how to raise any concerns they had, including if they were concerned about abuse.

Most people knew the staff who supported them and were very positive about the staff. The people we spoke with did not have any concerns about staffing levels, or about staff’s qualifications and skills to support them. One person told us, “I am happy with the standard of care I receive and I am very impressed with the professionalism in the team”. Staff we spoke with had varied views, particularly about staffing levels. Some felt the staffing was satisfactory, but others were of the opinion that too many staff were under too much stress for the service to be sustained.

The trust had maintained the improvements we had noted at a previous inspection, regarding the timeliness of reporting to CQC about incidents of concern and deaths of people who used services.

Only two people we spoke with or who contacted us were completely dissatisfied. One person related a series of events which they felt had not been a good experience for them, and another person told us they had decided not to continue using the service because they were not happy with it. They said staff did not listen to them or engage with them.

People told us that the treatment they had received was good and that their mental health had significantly improved as a result of their admission. One commented, “It’s helped me a lot – I’m a different person now”. Another person told us that since her admission, her medication had been completely reviewed and had greatly helped in stabilising her mood. One person particularly appreciated the daily routine on the ward and reported, “I enjoy the structure – it’s really useful – makes the day go quicker”.

People told us they had been involved in decisions in relation to planning and setting their care and treatment goals and that their treatment had been explained to them. One person informed us that their discharge date had been discussed at length with them and the date, although fast approaching, had felt right. People on Willow ward told us they really valued having their own room and ensuite facilities as it gave them greater privacy. However one person told us that there had been no hot water in her bedroom and that she had had to wash in cold water for the first few days after her admission. She told us she had reported this some three weeks ago but it was still not sorted, resulting in staff having to bring her bowls of hot water from a nearby bathroom.

Some people told us they wished there were more opportunities to get out of the ward and into the community. One person perceived this as a lack of appropriate staffing and commented, “Sometimes there aren’t enough qualified staff to take us out”. This person was also upset that they could no longer access the ward’s garden area as a new fence was being erected. This had meant that the regular gardening sessions, which she had enjoyed, had been cancelled.

During our review we spoke with a number of people who use the trust’s services.

Opinion regarding the quality of care experienced was mixed: some people felt their needs were being met while others did not. A number of people were able to confirm who their key nurse was and were aware of their care plans.

The trust also provided us with a copy of the results of a recently conducted independent survey of inpatients’ views of the service. This found that almost three quarters of the people who responded felt their overall care during their stay had been good, very good or excellent.

The majority of the people we spoke with considered staff to be supportive. A number stated that staff are very busy and they can not always get time with their doctor or named nurse.

We also asked people who use the service their opinion on the trust’s environment. Opinion was mixed, dependent on which service the person was using. People at the Cavell Centre in Peterborough were very positive about the environment while one person at Fulbourn Hospital was very distressed regarding her environment and stated that this made her ‘feel rubbish’.

We raised all of these issues with the trust’s management team immediately following each visit and have included a range of relevant actions for the trust to meet within this report.

This section was not completed for this inspection. More information about what we found during the inspection is available in the report below.

We found that patients had been given good information about their care and treatment and that they had been fully involved in their care planning. One patient told us that she had two named nurses who were, “Amazing, they’re really, really cool. I’ve lied my way through since I was 14. This is the only hospital where I’ve told the truth. We all support each other like one big family.” Patients had the opportunity to talk about issues during the daily community meetings. One patient told us, “If there’s a problem that affects one person, or everyone, or even if it doesn’t affect anyone, we talk about it. We support each other”. We noted that the quality of interaction between staff and patients was good, with staff showing genuine empathy and respect to people.

Patients care plans were comprehensive, were up to date and were regularly reviewed. Patients told us that they had a named nurse who they could talk to about their care needs but all felt that they could approach any regular member of staff is their named nurse was not present.

We saw that there was information available to patients which explained to them what abuse was and what they should do if they were concerned about themselves or another vulnerable adult. Staff we spoke with confirmed that they had received training in working with vulnerable people and knew what constituted abuse and how to report it.

Staff had received training in a range of topics and all staff spoken with told us that they felt supported by their colleagues. Staff told us that the training equipped them for their their role and that they had regular formal supervision.

Patients we spoken with where aware of how to make a complaint and there were posters and leaflets to remind them about this.