We have published our Mental Health Monitoring Annual Report 2023-24

During our inspection visits in 2023-24, we focused on several key areas including:

• Considering whether risk assessments and care planning were completed appropriately to ensure patients received safe and effective care.
• Considering whether patients were informed about their rights and whether they understood the significance of their care and treatment.
• Considering whether patients had access to meaningful and therapeutic activities, and whether their care was delivered with dignity and respect.

Despite some positive developments, mental health and learning disability services continue to face significant challenges. Workforce shortages and increasing service demands are affecting patient outcomes. Our work found health boards and independent providers are under sustained pressure to meet the diverse needs of vulnerable patients.

While the report acknowledges areas of good practice, there are critical areas where significant improvement is necessary. Variability in service delivery remains a concern, and healthcare providers must take urgent action to address these persistent issues.

Patient and family feedback continues to highlight the professionalism and compassion of staff. Many praised the proactive, engaging approach of staff to ensure patients fully understand their care and treatment. However, there are several areas of concern that require immediate action:

• Workforce challenges, particularly related to recruitment and retention of staff.
• Medicines management, with ongoing issues regarding storage, administration, and auditing of medications.
• Patient observations, including staff training, ineffective recording, and delays in reviewing policies and procedures.
• Availability of patient information, with some services lacking crucial details for patients on key topics.
• Risk assessments and care planning documentation, with incomplete assessments and delays in reviews.
• The environment of care, including a lack of audits and management of environmental risks, such as ligature risks.
• Governance, with insufficient oversight and audits in key areas, including staff training and compliance.

During this reporting period, we conducted 26 on-site inspections across both NHS and independent healthcare settings. We also jointly visited one Community Learning Disability Team (CLDT) with Care Inspectorate Wales (CIW) and one Community Mental Health Team (CMHT).

Additionally, we reviewed 199 complaints and concerns related to mental health and learning disability services, an increase from the previous year. Requests for visits by Second Opinion Appointed Doctors (SOADs) also rose, with 733 requests primarily focused on medication certification.

Chief Executive Alun Jones said: 

"This report highlights the importance of continuous improvement in mental health and learning disability services across Wales. While we recognise the positive feedback from patients and their families, we are acutely aware of the ongoing complex challenges impacting patient care. We are committed to driving improvement to enhance the safety and effectiveness of services, supporting providers to meet the needs of all patients with compassionate, high-quality care."

Mental Health, Learning Disability Hospitals and Mental Health Act Monitoring Annual Report 2023-24