Designing better mental healthcare facilities

CQC report highlights outdated facilities

In a recently published Care Quality Commission report following a comprehensive threeyear inspection of all specialist mental health services in England – rating services provided by 54 NHS Trusts and 221 independent mental health locations – inspectors express concerns about ‘the poor physical environment of many mental health wards’.

Section 2.2 of The state of care in mental health services 2014 to 2017, Findings from CQC’s programme of comprehensive inspections of specialist mental health services, notes that CQC inspectors concluded that ‘many inpatient facilities were not designed to meet the needs of the group of patients that are admitted to acute mental health wards today’. The section adds: “Their design does not permit staff to observe all areas easily, and many wards contained fixtures and fittings that people at risk of suicide could use as ligature anchor points.

A substantial number of services admitted both men and women to the same wards. We have taken action against services that did not follow NHS guidance on eliminating mixed sex accommodation.” Commenting more generally on services standards across English mental healthcare facilities, the CQC said: “As of 31 May, CQC inspectors rated 68% of core services provided by NHS Trusts and 72% of independent mental health locations as ‘good’, with 6% of NHS and 3% of independent core services rated ‘outstanding’. However, they also found too much poor care, and far too much variation in both quality and access across different services.”

CQC inspectors found ‘the clear majority’ of services were ‘caring and compassionate towards their patients’, with 88% of NHS and 93% of independent services rated ‘good’ in this key area, but also identified ‘several areas of concern’ – including difficulties around accessing services, ‘physical environments not designed to keep people safe’, ‘care that is over-restrictive and institutional in nature’, and ‘poor recording and sharing of information that undermines staff efforts to work together to make sure people get the right care at the right time’. 

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