A warning notice at a unit for children with severe mental health difficulties has been lifted.

However, inspectors have concluded that improvements at Forest House in Harper Lane, Radlett, must still be made.

The child and adolescent mental health service run by Hertfordshire Partnership University NHS Foundation Trust was given an “inadequate” rating by the Care Quality Commission in the spring.

Read more: Forest House given 'inadequate' CQC rating

“Significant shortcomings” were identified by the CQC in a report published on November 11, including concerns about the welfare of patients as well as about staff management and leadership.

The CQC revisited the 16-bed Forest House in July and found “enough improvement” had been made to quash a warning notice and move the unit from ‘inadequate’ to ‘requires improvement’.

Staff were found to understand how to protect youngsters from abuse and following criticism in the spring, were now using systems to safely prescribe, administer, record and store medicines.

Managers were also found to support staff with appraisals and supervision.

However, not all staff had reported incidents in line with trust policy and the ward had no call bell system for children and young people, which the CQC said could cause a delay in an emergency. The trust says it is now installing a call bell system in every bedroom.

Other concerns included the “consistent” quality of care being hampered because of the “dependency” on employing staff from agencies.

Read more: Fraud and assault allegations at Forest House in Radlett

The CQC’s head of hospital inspection, Craig Howarth, said: “I am pleased to see improvement at Forest House, but more work is needed to ensure all children and young people using the service receive the right care and support.  

“We’ve told Hertfordshire Partnership what it must do to improve the service further.  

“We continue to monitor it, including through future inspections, to assess whether progress is sustained and embedded.” 

Karen Taylor, chief executive at the trust, which has retained its overall 'outstanding' CQC rating, said: “We are pleased the work we have done to improve care and support for young people and their families has been recognised in this latest inspection report, but we also recognise we have further improvements to make.

“We have provided more training and support for staff, recruited more staff and improved how we involve and engage with young people and their families. 

“We are confident we will continue to the make the changes necessary.”

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