Care Inspectorate Wales (CIW) and Healthcare Inspectorate Wales (HIW) today publish their Joint Thematic Review of Community Mental Health Teams

Published today, this review brings together the key themes to have emerged from our joint-inspections of Community Mental Health Teams (CMHTs) across Wales, as well as engagement with people who use services, carers, and the third sector. 

The key themes to emerge from this review are: 

• Access to Services
• Care Planning
• Delivery of Safe and Effective Care
• Governance 

In relation, these themes we found disparity and variability in the standards, consistency and availability of treatment, care and support provided by Community Mental Health Teams across Wales. 

Findings:

• There is a lack of clarity regarding how people access CMHTs, with links between General Practice (GPs) and CMHTs needing to be strengthened. In some areas there is a lack of knowledge of the range of services available for people to be referred to.
• We are concerned about the ability of people experiencing mental health crisis to access urgent support. Some service users have difficulty accessing services out of hours or have to attend A&E departments. A significant number of people did not know who to contact out of hours. 
• Service users or families are not being fully involved in developing care and treatment plans. 
• Whilst CMHTs are meeting targets for the completion of assessments and/or care plans, we have found that this does not always mean that the quality of documentation is good
• There are significant challenges for people who need to access psychology or therapeutic services with long waiting times in Wales; up to 24 months in some areas.
• In some areas there are problems in accessing some third sector or other support services, which means that the invaluable support those services can offer is not being used fully or effectively.
• There is much work being undertaken on the transformation of services across Wales, which is positive. However, focus needs to be maintained on ensuring service users continue to receive appropriate care whilst wider changes are being made.
• Information technology and universal access to patient/service user records is a considerable problem across CMHTs with health and social care service systems not working together properly.
• The working environments of CMHTs need improvement with some clinical areas is not fit for purpose.