Initially, this post was planned to challenge the accuracy of the latest Care Quality Commission Inspection Report on Southern Health NHS Foundation Trust and the flattering media reports, which followed, such as in ‘The Oxford Mail’→
However, sources close to the NHS have informed CRASH that an independent report by leading Counsel will shortly be published by NHS England or NHS Improvement and that this report will in itself disabuse the CQC of many of the claims it made about the Trust.
The report was circulated today – but withdrawn within an hour – not before it had been leaked anonymously. However, in fairness to those involved, we will not comment until it is republished. Instead, we will let the CQC’s recent record speak for itself. Readers can decide, which of the categories in the above image apply.
In November 2019, the Joint Parliamentary Committee on Human Rights (“JCHR”) published its 2nd Report (2019 session). The JCHR heavily criticised CQC inspections an, at chapter 7, point 157 of the report concluded of the CQC:
“A regulator which gets it wrong is worse than no regulator at all.”
Also, the JCHR also concluded at chapter 7, points 123 to 157, (amongst other things):
1. The CQC, as regulator, should be a, “Bulwark” against human rights abuses of those detained in mental health hospitals. Its ability to protect patients against human rights abuses is, “Impaired” and, “Urgent reform” of its approach and processes is, “Essential”.
2. Concerns raised by patients and family members about treatment must be recognised by the CQC as constituting evidence and acted upon.
3. A review of the system which currently allows a service to be rated as, ‘Good’ overall even when individual aspects, such as safety, may have a lower rating.
The JCHR’s inquiry was triggered in May 2019 when BBC Panorama exposed serious abuse and mistreatment of vulnerable adults at Whorlton Hall. The CQC’s then-deputy chief inspector of hospitals, Dr Paul Lelliott told Panorama:
“On this occasion it is quite clear that we did not pick up the abuse that was happening.”
Health Service Journal analysis also showed that, after the Whorlton Hall scandal, the CQC down-graded six mental health hospitals to, “Inadequate”, just months after describing them as either, “Good” or, “Outstanding”!
The CQC also rated Norfolk and Suffolk Foundation Trust, “Requires improvement” for whether services were safe, responsive, effective and well-led and, “Good” for whether services were caring. But Healthwatch Suffolk said there was:
“A disparity between what the trust reports, the outcome of this inspection and the experiences of service users and carers”.
And the local service users’ champion said it had noticed:
“Very little improvement in peoples’ recorded feedback”.
Pass the sick bag!
However, the evidence suggests these criticisms can be levelled at the CQC’s latest inspection report on Southern Health, despite the appointment of a new Deputy Chief Inspector Mental Health & Community Services, Dr Kevin Cleary. CRASH knows that Dr Cleary and his inspectors had evidence, which they clearly ignored. Wilful blindness?
Moreover, as recently as 21 January 2020, ‘The Times’ reported that, during an audit, the CQC found, “Duplicate material” in 78 reports, with identical quotations from patients or sections of evidence pasted into reports on different institutions. As a result, the CQC has decided to carry out several re-inspections. Read more here→
In all the circumstances, the CQC report on Southern Heath, which (in our opinion) deflects the truth and contains terminological inexactitudes¹ should be treated with a huge bucket of salt.
We await the new report but it begs the question – did Dr Nick Broughton jump ship before the truth was out?
On an entirely different subject, Sir Keir Starmer MP told BBC News:
“I know from running a big organisation that, if you’re going to change the values and the culture of the organisation, you’ve got to do it from the top down”
No-one doubts there are dedicated and caring staff working at the coal face in Southern Health. What the ‘new leadership’ has failed to demonstrate is a good culture at the top.
“Teams and their members take fewer risks and stop fighting for new insight when they have processes to protect them. It’s not intentional, it’s a function of our innate propensity to seek homeostasis…a comfortable, predictable environment.”
Yet all we see at Southern Health are lots of systems, planning, strategies, consultations and meetings but no change in culture!
In short, CRASH is not alone in believing Southern Health remains, what the BBC termed, a, ‘Broken Trust.’
The CQC should be downgrading Southern Health just as it has downgraded six others.
² The book, ‘The Military Leader’ is available from Amazon and other bookshops. With more than 20 years of combat-tested leadership experience, Andrew Steadman knows what it takes to build teams and grow leaders. Drawing from his highly successful career as an Army Infantry officer, he wrote ‘The Military Leader’ to be a foundational leader development resource for leaders of all professions.
“An excellent book on leadership! The lessons and techniques can be used by leaders in all industries and organizations.”
Having read the book, this comment applies especially to leadership in the NHS.