Wards managed by the NHS trust in charge of mental health services for the Wiltshire area have been rated as requiring improvement.

The Care Quality Commission made an unannounced visit to the forensic inpatient and secure wards run by Avon and Wiltshire Mental Health Partnership NHS in January 2024 after receiving concerns from users and their families about the quality of care being provided.

The results of the unannounced inspection are about to be published.

Inspectors found that little had changed since the previous inspection in July 2023 as staff shortages were having a negative impact on how patients were being looked after.

CQC deputy director of operations in the south, Catherine Campbell, said: “When we inspected the forensic inpatient and secure wards run by Avon and Wiltshire Mental Health Partnership NHS Trust, we found very little had been done to improve people’s care since our previous inspection in July last year.

“We saw people’s care was being impacted by staff shortages, which was causing an over-reliance on agency staff who weren’t as familiar with the service or people’s individual needs.

“Nurses in charge of the ward told us they often had to ask staff to stay on past their shift to cover short notice absences of other staff and that the quality of some agency staff was poor which added extra pressure for permanent staff.

“People using the service also told us some staff weren’t always respectful towards them, which was something CQC has told the trust to address previously.

“Staff shortages were also impacting people’s freedom to use all of the public spaces at the service, such as not being able to use the garden at night as there weren’t enough staff to support people with access.

“However, it was positive to see blanket restrictions on people having access to the garden during the day had been removed.”

Following the inspection, the Safe category has also been re-rated as requires improvement and responsive is re-rated as good.

Inspectors did not assess how well-led, and caring the service was, so both remain rated as good, and how effective the service is was also not assessed and remains rated as requires improvement.

The overall rating for Avon and Wiltshire Mental Health Partnership NHS Trust is unaffected and remains requires improvement.

Catherine Campbell added: “Leaders had responded appropriately to a number of care concerns and suspended staff from duties whilst investigations took place.

"However, they didn’t always make sure staff followed the trust’s own policies which may avoid some of these incidents happening.

“Staff also told us they were still anxious about reporting incidents and speaking up when things went wrong, due to concerns about their job security if they did so.

“Leaders told us they were taking steps to address these issues by providing more training and staff said this was helping to improve the culture.

“We have informed the trust where they need to make improvements and we’ll continue to monitor them to keep people safe whilst they are doing so and well return to check on their progress.”

People had requested different activities and food options but staff had not taken action to meet these requests.

The ward had activity boards displayed with pictorial references to help with communication, but the boards did not accurately reflect the activities that were provided and were not updated often.

Relatives said they did not always feel involved in the care planning of their loved one.

However, the service had the right policies and procedures in place to handle incidents.

Safety incidents and complaints were treated as opportunities to put things right, learn and improve.

Staff understood duty of candour and were open and honest with people and their families when things went wrong.