Independent investigation: Lesley Wright, Tooting (2006)

The PCT and the trust should review the range of specialist mental health services available through primary care in line with the expectations of the national service framework for mental health services.

The trust should ensure that managers allocate cases in a timely way after a request from a GP for an urgent assessment under the MHA.

The trust should ensure that team managers implement the CPA policy and procedures, that all CMHT staff have training and refresher training in the operation of the CPA and that risk assessments are completed as part of the CPA process. … Read more The trust should ensure that team managers implement the CPA policy and procedures, that all CMHT staff have training and refresher training in the operation of the CPA and that risk assessments are completed as part of the CPA process. The trust should undertake frequent audits to ensure compliance with this recommendation. Show less

The trust should ensure that all CMHT staff have training in safeguarding and the protection of vulnerable adults.

The trust should ensure that a senior manager has responsibility for linking with other partners in the Safeguarding Adults Partnership.

The trust should ensure there is improved liaison between its CMHTs and the local authority teams for adults and older people.

The trust should ensure that all staff have training in assessing the needs of carers and are aware of their duties under the Carers (Recognition and Services) Act 1995.

The trust should review the roles of clinical team leader and team manager to ensure clarity about decision-making within the CMHT. The trust should ensure there is clear clinical leadership in decisions where action under the MHA is requested.

The trust should ensure that clinicians are aware of the range of social interventions available for patients referred to the service, including carer’s assessments.

The trust should ensure that managerial supervision meetings take place as required, are recorded, and include a full discussion of the operational issues in the manager’s remit. The trust should ensure that managers report operational difficulties systematically and in a … Read more The trust should ensure that managerial supervision meetings take place as required, are recorded, and include a full discussion of the operational issues in the manager’s remit. The trust should ensure that managers report operational difficulties systematically and in a timely way through the management line. Show less

The trust should ensure that professional supervision takes place as set out in the trust policy and that it is recorded and decisions acted upon.

The trust should monitor compliance with its policy on notifying primary care services when patients do not attend appointments (the DNA policy).

The PCT and the trust should review practice and procedures for the management of referrals of patients whose mental illness makes them reluctant to engage with services.

The trust should ensure that all CMHTs are given clear guidance on the standards for recording team meetings. Records of team meetings should show who attended, the range and content of discussion on individual cases and the decisions made by … Read more The trust should ensure that all CMHTs are given clear guidance on the standards for recording team meetings. Records of team meetings should show who attended, the range and content of discussion on individual cases and the decisions made by the team. Show less

The trust should ensure that managers regularly audit records of team meetings to assess their quality and compliance with trust standards.

The trust should ensure that operational managers monitor the impact of sickness absence and take action to minimise its effect on the functioning of CMHTs.

The trust should ensure that all team members maintain trust standards for case recording.

The trust should ensure that as far as possible case notes are always available for outpatient appointments wherever they take place.

The PCT and the trust should clarify the systems for GPs requesting action under the MHA. The trust should ensure that all CMHT staff who act as the first point of contact are clear about expectations and responsibility for follow … Read more The PCT and the trust should clarify the systems for GPs requesting action under the MHA. The trust should ensure that all CMHT staff who act as the first point of contact are clear about expectations and responsibility for follow through action after requests are made for assessment under the MHA. Show less