Creating more-therapeutic environments for mental health

Psychiatric services come under the spotlight as the CQC announces update to inspections framework

Health regulator, the Care Quality Commission (CQC), has announced plans to launch a new mental health assessment framework – the first major update in the way inspections are carried out for at least three years.

Speaking at the recent Design in Mental Health Annual Conference, Jane Ray, head of hospital inspection for mental health and community mental health services at the CQC, said focus areas are likely to be linked to the main concerns currently reported by inspectors.

These include sexual safety on mental health wards, access to call alarms for staff and patients, use of physical restraint, ligature risk, and clinical information systems.

And it will be further informed by feedback gathered from service users, who cited lighting, noise, smells, same-gender care, and access to possessions as important.

As good as it gets

Ray told the conference: “It is so important that the environment is as good as it can be, and we can make things better for people.”

Wards for people with learning disabilities and autism, acute adult psychiatric wards, and intensive care units for children and young people with mental health conditions are among those most in need of improvement, she added.

The environment needs to be therapeutic and if we did that right the environments would be much safer by default

“These, I have to say, are often environments that when we go in, they feel anything but therapeutic,” she said.

Commenting on the proposed changes, she told delegates: “There are a number of key messages from the CQC about the way forward.

“Firstly, it’s vital to involve people who use services in design work.

Safer by default

“Remember, the environment needs to be therapeutic and if we did that right the environments would be much safer by default.”

Designing environments and services to improve staff wellbeing and retention will also be central to achieving good ratings moving forward.

She said: “We want trusts to really think about the quality of care and how they deliver it and to remember the wellbeing of staff.

“We know how challenging it is for staff and if you think carefully about staff it will help to make things safer and more caring for patients.”

She concluded: “We are thrilled the Department of Health and Social Care has given £400m in funding to abolish dormitory-style wards. This will improve the individual care that can be given to patients and patient safety.

“It is an absolutely-shared vision for everybody to create more-therapeutic environments.”

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