Following an inspection by the Care Quality Commission (CQC) in February 2023, the women’s forensic inpatient services also known as secure wards at West London NHS Trust has been rated as requires improvement for being safe.
In response to concerns raised with the CQC, inspectors visited the women’s forensic service at the Orchard Unit which is located on the St Bernard’s Hospital site in Southall next to Ealing Hospital.
The Orchard unit provides 60 beds across 6 wards and offers care for women who have mental illness or a personality disorder. Care is provided in three settings, low, medium or enhanced.
Click here to download the inspection report by the Care Quality Commission
Among the concerns which the CQC highlighted :
- Some people were separated long-term from others. This was due to their distress posing risks to other people in the service. These people did not always have enough involvement in their care plans, and those plans didn’t always have enough detail on how to end this separation.
- Some people who needed to be observed by staff on a regular basis to ensure their safety and wellbeing were being checked at predictable times. This predictability of timing could endanger people at risk of harming themselves as they may be able to assume times they won’t be checked on.
- Families and loved ones who were involved in the care of people at the service were not always aware of the provider’s carers’ forum. The carers’ forum supported families and loved ones to provide feedback on the service.
West London NHS Trust said it is addressing the concerns raised in the report.
As the CQC did not have any other concerns raised for it to investigate, the previously given overall rating for the Trust remains Good and forensic inpatient wards remain outstanding overall.
In a statement following the inspection, the CQC said: “Following the inspection, the Trust’s women’s forensic inpatient services were rated requires improvement for being safe. It was not re-rated overall or for the other key questions. Therefore, the forensic inpatient wards at the trust remain outstanding overall. The overall rating for West London NHS Trust remains rated as good.”
Explaining the findings, Jane Ray, CQC deputy director of operations in London and the East of England, said: “During our inspection of the trust’s forensic services we were concerned to find some practice which risked people’s safety, despite a positive and people-centred culture.
“We found some people who needed to be observed by staff on a regular basis to ensure their safety and wellbeing were being checked at predictable times. This predictability of timing could endanger people at risk of harming themselves as they may be able to assume times they won’t be checked on.
“We also saw a high vacancy rate due to a national shortage of nursing staff, with agency staff filling roles instead. Leaders acknowledged that this risks people being cared for by staff less familiar with them or the service.
“However, people and their loved ones said they felt the service was safe. People were given well-informed care plans focused on recovery and provided a range of treatments in line with best practice.
“Inspectors also saw a strong person-centred culture which catered around people’s individual needs and involved them in developing the service.
“We have shared our findings with the trust so they know where improvements must be made and where there is good practice to build on. We’ll continue to monitor the service to ensure people’s safety.”
West London NHS Trust was also recognised by the inspectors in a number of ways that the CQC highlighted including:
- Ward environments were safe and clean, and staff managed risks to people well.
- People were provided care in line with best practice because staff used audits to benchmark care.
- There was excellent feedback from patients and carers in regarding their care and treatment.
- People in the service were given communication, advocacy, cultural and spiritual support, aided by staff. Inspectors saw numerous examples of people involved in the development of the service, including through focus groups on the use of restraint.
West London NHS Trust said it is addressing the concerns raised in the report.
Dr Catherine Penny, clinical director for West London Forensic Services (WLFS) said: “We are delighted that the women’s unit at the Orchard, part of our forensic service, remains rated as Outstanding overall by the Care Quality Commission. It’s heartening to see the many positives noted, including the outstanding practice in co-production, with our patients empowered as partners in their care and service development. Feedback was excellent from patients and carers regarding their care and treatment.
“We note the concerns raised in the report and are addressing these, including rapidly working to ensure our policy to complete and evidence enhanced observations at unpredictable times is followed consistently across the service.
“We are pleased to see the positive feedback in relation to care plans, managing risk, cleanliness and infection control, staff treating patients with compassion and kindness, and use of restrictive interventions”.
To view the full report of West London NHS Trust, click here.
 in February 2023, the women's forensic inpatient services also known as secure wards at West London NHS Trust has been rated as requires improvement for being safe. ){kind=link}