Introduction

BIRMINGHAM, UK — The Care Quality Commission (CQC) has once again rated the Birmingham and Solihull Mental Health NHS Foundation Trust as “requires improvement” following its latest inspection, with particular concerns raised about the Reaside Clinic, a medium-security forensic unit in Rednal.

🛏️ Environment and Safety Concerns

Inspectors found a host of unacceptable environmental conditions across the forensic wards. Issues included damaged furniture, mould-infested showers and sinks, urine on toilet floors, and persistent graffiti that had not been promptly removed. The CQC warned these failings not only posed hygiene risks but also compromised patient dignity and safety.

As a result, the trust was served a warning notice, citing breaches in governance, insufficient staffing, and failure to consistently respect patients’ rights.

🗣️ Staff Training and Availability

Another area of concern was staff training. The inspection revealed that some staff lacked up-to-date qualifications in life-support and safeguarding, critical for working in secure mental health settings. Additionally, a shortage of trained personnel on certain shifts meant escorted patient leave was cancelled and therapeutic activities were reduced — further impacting the well-being and recovery of service users.

🧑‍⚕️ Person-Centred Care and Patient Involvement

The CQC also highlighted inadequacies in person-centred care. Some care plans were outdated or not tailored to individual patient needs, violating NHS regulations. While many patients felt safe and generally trusted staff, others noted that overworked staff appeared less empathetic, resulting in inconsistent care experiences.

🏥 Forensic Services Remain Under Scrutiny

Overall, forensic inpatient services were rated as “requires improvement” in safety and effectiveness. This also applied to the Forensic Intensive Recovery and Support Teams (FIRST), which were evaluated during a Section 31 investigation following a serious incident.

✅ Signs of Progress

Despite the criticism, the trust has made notable progress in certain areas. Since the previous inspection, some clinical governance issues have been addressed, and several regulatory breaches have been lifted. Notably, community mental health services have improved, earning a “good” rating for being safe, effective, and well-led.

Staff were also praised for their ability to de-escalate difficult situations compassionately and for showing a renewed commitment to respecting patient dignity.

🧠 Leadership and Strategic Direction

Leadership at the trust has seen a significant overhaul, including the appointment of a new CEO, a restructured board, and a clearer strategic focus. These changes were acknowledged as key steps in the trust’s improvement journey.

However, inspectors noted a lingering gap in visible leadership, with not all staff aware of who their leaders were — a sign that more work is needed to ensure cohesive oversight and communication across departments.

📝 Recommendations Moving Forward

CQC Deputy Director for the Midlands, Amanda Lyndon, issued a clear set of priorities for the trust:

• Swift refurbishment and cleaning of ward environments to meet safety and dignity standards.

• Completion of essential training for all staff, particularly in safeguarding and life support.

• Improved staffing levels to support patient engagement, escorted leave, and safe oversight.

• Stronger patient involvement in care planning, with regular updates to reflect evolving needs.

• A more visible and consistent leadership presence, supported by regular incident audits.

📌 Conclusion

While the Reaside Clinic and related forensic services continue to face serious challenges, the Birmingham and Solihull Mental Health Trust is making incremental progress, particularly in community settings and governance. With regulatory scrutiny ongoing, the coming months will be critical in determining whether these improvements translate into safe, personalised, and dignified care across all services.