CNTW receives a requires improvement rating for leadership from the CQC

The trust provides specialist mental health services. NHS trusts are currently given a single trust-level rating focusing on leadership and culture.

During the inspection, which took place from September 30 to October 2, the CQC found that the trust was in breach of regulation regarding its management systems as leaders did not always have effective processes in place to consistently assess, monitor and drive improvement in the quality and safety of its services.

CNTW says it has accepted the findings of the report – both the positive work that it does and the improvements that need to be made – and it has “already begun work to address these issues”.

Gemma Berry, CQC deputy director of mental health in the North East, said: “We found the standard of care had deteriorated in some services since our last inspection.

“Senior leaders didn’t always have appropriate systems and processes in place to monitor this and keep people safe.

“This meant leaders couldn’t always take effective and timely action to address risks which could result in people coming to harm. For example, improvements were needed around staff safety, reducing restrictive interventions, managing environmental risks and improving staff training.

“Also, some staff didn’t feel safe speaking up when they had concerns, including those which could impact the quality and safety of people’s care. They told us they weren’t confident that their feedback would be acted on and lead to improvements.

“However, we saw examples of great partnership working to help improve the health and wellbeing of people and local communities. Such as working with the local integrated care board on the ‘better health and wellbeing for all’ strategy, which focuses on reducing inequalities, improving life expectancy, and giving children the best start in life.”

The CQC previously rated how well-led the trust is as outstanding in an inspection using its previous methodology for trust ratings.

James Duncan, CNTW chief executive, said: “We accept the findings of this report and recognise the seriousness of what the CQC has set out.

“The CQC has identified that our systems for identifying, escalating and addressing concerns about quality and safety are not working consistently enough. We accept that this must improve.

“The CQC is clear that our staff continue to deliver compassionate, safe and respectful care, often under significant pressure. Feedback from patients and carers about their day-to-day care, staff kindness and involvement in decisions has been positive. The CQC also recognised our focus on innovation, improvement and continuous learning.

“At the same time, the report highlights areas where we must do better. In particular, it makes clear that we need more consistent and effective leadership at all levels of the organisation.

“We have already begun work to address these issues. We are strengthening leadership development and simplifying our processes for managing the organisation. We are improving how we listen to staff, act on concerns and involve them in decisions.

“But I am clear that this now needs to move faster and be felt equally and effectively across the organisation. I understand the urgency of this and we are actively addressing all of the areas the CQC has highlighted.”