Mersey Care: 'Gaps in knowledge' at trust linked to killings
"Gaps in staff knowledge" sparked a review into a mental health trust linked to suicide attempts and killings, including two children.
Liverpool Clinical Commissioning Group's report said it was "unclear" if all staff at Mersey Care NHS Foundation Trust had sufficient skills do the job.
Staff were often left to work alone and were criticised for not listening to patients' families.
Mersey Care said "a programme of improvement" had been put in place.
The report highlighted incidents including:
- A man who stabbed his mother to death before attempting to stab his grandmother after being assessed by the unit
- A man who was charged with the murder of his wife and two young children after taking medication including antidepressants
- A man who slit the throat of his ex-partner's new partner even though he was not deemed to be "acutely unwell"
- Three female patients who fell from the multi-story car park at Aintree Hospital in the last 18 months, one of whom had taken an overdose
The report said the same themes contributed to the incidents, namely not listening to the concerns of the patients' families, including one family who were "not engaged at all despite them being in the unit".
It also said: "It is unclear if all practitioners have a formal mental health qualification.
"The investigation identified gaps in staff knowledge and not all staff have the skills required to function as lone workers."
Work should also be done to make Aintree Hospital's car park more secure, it said.
It recommended staff training and better risk assessments, some of which have already been implemented.
A spokesman for Mersey Care NHS Foundation Trust said: "We are aware of incidents involving service users at the University Hospital Aintree and we are conducting an ongoing review into the circumstances leading up them alongside colleagues from the Aintree University Hospital NHS Foundation Trust.
"As regards mental health assessment training of staff, a programme of improvement has been put in place to raise the skills of staff in relation to risk assessment."
A spokesperson for Aintree University Hospital added: "We are working closely with colleagues at Mersey Care and Merseyside Fire and Rescue to review the existing safety measures in place on the multi storey car park and to determine what further measures can be taken."