Written Statement - Ministerial Spot Checks of Older People’s Mental Health Wards in Wales – Publication of Reports

A national report about the findings of a series of 22 unannounced spot checks carried out by an independent team of senior professionals to review care and conditions on older people’s mental health wards across Wales is today being published.

Reports detailing the findings at a health board level are also being published today.

The spot checks, which followed and built on a series of unannounced reviews of care for older people being treated on medical wards in district general hospitals last year, focused on 7 fundamental aspects of care:

• Eating and drinking
• Use of restraint and safeguards
• The use of medications, including giving patients their medication and the prescribing of sedatives and antipsychotics
• Continence and personal care
• Daily activities
• Relatives and carers and their involvement in care
• Culture and leadership.

The spot checks – which were undertaken in 22 of the 51 older people’s mental health wards in Wales between November 20 and December 18, 2014 – revealed areas of good and excellent practice across Wales together with areas which required improvement.

In the main, they found staff who were doing their best to provide good quality care in the face of a number of challenges. Where the team of reviewers discovered and highlighted immediate concerns, these were raised with the health board immediately to take urgent action.

The teams identified variation in practice within and between individual wards in health board areas. However, they did not find a repeat of the serious failings, which have been identified in an independent report about Tawel Fan ward, in Ysbyty Glan Clwyd, North Wales.

A number of key recommendations have emerged from the spot checks, including:

• Ensuring older people have access to daily activities on wards - constructive failure-free activities are known to be of therapeutic benefit
• Staff need to feel they can raise concerns easily; have effective training and understand the necessary legal safeguards
• The need for improvements to ward environments, in particular ensuring simple maintenance tasks and repairs are undertaken promptly
• Flexible visiting hours should be encouraged on wards.

The spot checks have provided us with assurance that poor care and neglect are not systemic features of the care of elderly mental health patients in Wales, although the report does acknowledge there is room for further improvement. I expect health boards to continue to develop and improve services for older people with mental health problems both in hospitals and in the community.

To support this and to take forward some of the key findings from the spot checks, I have announced that more than £5m a year will be invested in the NHS to provides psychiatric liaison services at our district general hospitals and ensure that daily activities are available on all older people’s mental health wards.

I have also asked Public Health Wales to create an older people’s mental health community of practice so best practice and innovation can be shared across Wales.