Staff praised for care they provide in CQC report

CQC Inspection Report –
Blackpool Teaching Hospitals NHS Foundation Trust

 

  • Community Health Services for Adults rated as Outstanding
  • Trust rated as “Caring’’ across all services
  • Trust is Well Led

The Care Quality Commission (CQC) has published its report following an inspection of Blackpool Teaching Hospitals NHS Foundation Trust.

The unannounced visits carried out in November and December 2017 focused on acute and community services at the Trust.

The report gives an overall rating and individual ratings for a number of services.  The Trust received a Good or Outstanding rating for the vast majority of core services included in the report and received a Good or Outstanding rating for ‘caring’ in all our services.

This was the first time the Trust’s community health services for adults, community health services for children and young people, sexual health services and specialist community mental health services for children and young people had been inspected by the CQC and we are delighted to see that the inspectors rated those services as Outstanding and Good.

Inspectors found examples of outstanding practice in community services for adults, community health services for children and young people, dental health, sexual health services and surgery.

Inspectors undertook a well-led review in December and rated the Trust as Good reporting that that the organisation is well-led with an experienced leadership team with the skills, abilities and commitment to provide high quality services. There have been a significant number of improvements since the Trust underwent its last comprehensive inspection in 2014:

  • Surgical services improved to Good overall.
  • Medical care including older people’s care improved to Good overall.
  • Urgent and emergency care services maintained their rating of Requires Improvement. The report recognises that the Trust was inspected during the busiest November and December periods the Trust has ever had with unprecedented levels of demand.

The Trust’s Overall Ratings were:

 

Service Overall Rating

 

Medical Care (including older people’s care) Good
Surgery Good
Critical Care Good
Services for Children and Young People Good
End of Life Care Good
Maternity and Gynaecology Good
Outpatients and diagnostic imaging Good
Urgent and Emergency Services Requires Improvement
Clifton Hospital  
Medical Care (including older people’s care) Good
Outpatients and diagnostic imaging Good
Fleetwood Hospital  
Outpatients and diagnostic imaging Good
Community Services  
Community Health Services for Adults Outstanding
Community Health Services for Children and Young People Good
Community Dental Services Good
Sexual Health Good
Mental health Services  
Specialist Community mental health services for children and young people Good

 

The Trust was also rated over 5 core areas

 

Service Overall Rating

 

Are services safe? Requires Improvement
Are services effective? Good
Are services caring? Good
Are services responsive? Requires Improvement
Are services well led? Good

 

The Trust has maintained its overall rating of Requires Improvement.

Chief Executive of Blackpool Teaching Hospitals NHS Foundation Trust, Wendy Swift said: “The report showed that the vast majority of services are rated as Good or Outstanding which is an exceptional result.

“There are some real highlights in the report including the Outstanding rating for our community health services for adults. It is the first time these services have been inspected and the Inspectors were full of praise for the way the Trust has developed integrated care across a wide range of agencies to deliver the best possible care for our patients.

“Another highlight was the praise for kind, caring and respectful staff  doing their utmost to involve patients and those close to them in their care.

“We are extremely proud of our staff and we are delighted that they have been recognised for their efforts.’’

Marie Thompson, Director of Nursing and Quality at the Trust, said: “As we would expect, the CQC identified areas for improvement and we are determined to do all we can to make the necessary improvements to develop and further improve the quality of care we give to our patients.

“We recognise that the main focus for improvement is the Fylde coast health economy’s Urgent and Emergency Services. These services nationally and locally have been under great pressure and we have just faced the most challenging winter period ever seen on the Fylde coast.

“Through all this our staff have again been working incredibly hard to deliver effective, caring services in the best way possible. We are reviewing our processes to help them and to further improve services inside and outside of the hospital setting.

“To achieve this we are working closely with all Fylde coast health and social care partners to produce more responsive systems of care to transform out of hospital and in hospital pathways of care.’’

Prof Mark O’Donnell, Medical Director, added: “The levels of care and commitment at the Trust are exceedingly high and patient safety is our number one priority. I believe we have massive strengths, which have helped us make real progress over the last few years but we are committed to making further improvements and tackling the issues identified by the CQC report to further enhance our patient care”.

Speaking on behalf of the Fylde coast clinical commissioning groups (CCGs) Dr Amanda Doyle, chief clinical officer at NHS Blackpool CCG, said: “We are pleased to see that the CQC found numerous good or outstanding areas during their inspection at the Trust.

“As a whole health and care system on the Fylde coast, we work closely to provide the best possible services and outcomes for our residents, that includes making the necessary improvements where required.

“As acknowledged within the report, we’ve already seen huge success over the last couple of years in improving care for people away from the hospital setting through the introduction of neighbourhood care teams and specialist ‘extensive’ support for complex, often elderly patients. These new ways of working have not only improved the health and wellbeing of local people but also helped reduce the demands upon services as a result.

“Like many other areas in the country, our local urgent and emergency care system was under unprecedented pressure during the winter period.

“Staff across the whole Fylde coast health and care system have worked tirelessly and continue to do so to make sure patients receive the best possible care. The issue of waits and delays in the urgent and emergency services is not a problem which we can solve overnight but by continuing to work together as one Fylde coast wide health and care system we are confident that it is something which we can improve.”

Report Findings

The report highlights a number of areas of Outstanding Practice including:

  • A successful multi-speciality vanguard extensive care service that provides co-ordinated and integrated care for patients.
  • An Enhanced Primary Care Service for people with complex conditions
  • A Fylde coast Intravenous nurse-led Therapy Service.
  • A Care Home Team in Blackpool, Fylde and Wyre that looks after 14 residential care homes.
  • An “Empowering Families’’ initiative where professionals work with a particular group of children to reduce hospital admissions and GP attendances.
  • A focus on involving children in service development via several different processes including a Charter of Promises and a youth forum called Victoria’s Voice.
  • A Paediatric Patient Experience Officer who helps develop care for young people.
  • A Dental Anxiety Management (NDAM) Service which helps patients overcome their anxieties with regards to dental treatments.
  • Community services for adults, community health services for children and young people and sexual health services.
  • A bespoke patient tracker system across the acute hospital.
  • Innovative developments in the sexual health service.
  • Involvement with the Better Start Programme in Blackpool.

Positive findings included:

  • A strong patient focus with a culture centred on the needs of people who use services with systems in place to gather people’s views to use patient experiences to improve services.
  • A clear vision and strategy developed in consultation with staff, patient representative groups and external stakeholders.
  • Robust arrangements for identifying, recording and managing risks, issues and mitigating actions.
  • A strong sense of integration across acute and community services
  • Evidence that the Trust strategy was helping to have a positive effect on mortality figures.
  • Staff provide care and treatment based on national guidelines and evidence and use these to develop new policies and procedures.
  • Staff work together as a team for the benefit of patients and are kind, caring and respectful of patients’ privacy.
  • Staff involve patients and those close to them in their care.
  • Staff feel positive and proud about working for the Trust and for their team.
  • The Trust plans and provides services in a way that meets the needs of local people. There were a number of different initiatives particularly across community services such as the Extensive Care service.

Inspectors said the Trust’s main challenges are:

  • Ensuring that performance improves in terms of patient flow, meeting the four hour standard for admission, transfer or discharge and ensuring that patients with mental health illness receive assessment in a safe and appropriate environment.
  • Staffing levels in some areas of the Trust: this leads to pressures in ensuring the service has enough staff with the right qualifications, skills, training and experience to provide the right care and treatment.
  • Although Standardised Mortality figures remain higher than expected inspectors saw evidence that the strategy to reduce these was having a positive effect.
  • To ensure that mandatory training in each area is completed to the Trust target.
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