England’s Chief Inspector of Hospitals has rated the services provided by Staffordshire and Stoke on Trent Partnership NHS Trust as Requires Improvement following an inspection by the Care Quality Commission.
The CQC inspected the core services provided by Staffordshire and Stoke on Trent Partnership NHS Trust between 2 and 6 November 2015.
A team of inspectors, which included a variety of specialists and experts by experience visited hospitals and services provided by the trust and full reports of their findings, including ratings for all of the provider’s core services are available at: www.cqc.org.uk/provider/R1E
The CQC has rated the trust as Requires Improvement overall. It was rated as Good for being caring, Requires Improvement for being safe, effective, responsive, and Inadequate for being well-led.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“Following our visit, our inspectors found that improvements were needed at Staffordshire and Stoke on Trent Partnership NHS Trust.
“We were concerned about a number of services the trust provided and we issued a warning notice setting out areas where immediate improvements were needed. We received an action plan from the trust setting out the steps it intended to take regarding the immediate issues we raised.
“There were significant staffing shortages in community services for adults. This led to poor and unsafe practices such as shifts commencing with no trained nurse on duty.
“The system for assessing staffing levels was ineffective and there were substantial staff shortages affecting the ability to provide care. Demand for community nursing visits routinely outstripped capacity, with visits regularly postponed or cancelled. Staff routinely worked extra hours to meet patient needs
“Staff in community services for adults were under significant workload pressure resulting in low staff morale. We did not see adequate action from the senior management or the trust executive to manage the significant issues that threatened the delivery of safe and effective care.
“There was limited evidence that the strategy for the organisation had been articulated in a way that meant it could be communicated and understood by staff. Few staff we spoke with during the inspection understood the trust values. Governance arrangements were in place but were inconsistent and not well managed across the organisation.
“In addition, there was no credible statement of vision or strategy for end-of-life care services. Systems and processes to assess, monitor and improve the quality and safety of services were not sufficiently established or operated. Prescribing practices in this area were poor; there were no formal arrangements in place to support and oversee the prescribing practice and competence of the palliative care nurse consultants.
“It must be noted, however, that staff were caring and supportive towards their patients. Despite the challenges in some areas with workload, staff put their patients at the heart of their work which is why we rated the trust as Good for being caring.
“Feedback from people and their relatives who used services was positive about the way staff treated them. Our inspectors saw staff taking time to listen to patients’ concerns and explaining care plans in clear, simple language to make sure patients understood what was going to happen.
“Since our inspection we have been monitoring the trust and working closely with the Trust Development Authority and other stakeholders, such as the local Clinical Commissioning Group and NHS England.
“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”
The CQC has told the trust to take action in several areas, ensuring that:
- Staffing levels in community adult nursing are sufficient to ensure that patients receive safe and effective care in a timely way and that this is continually reviewed using a systematic approach to determining the number of staff and range of skills required.
- Caseloads and workloads of staff are reviewed in the community adult teams to ensure that the significant issues that threatened the delivery of safe and effective care and addressed and mitigated.
- The nurse consultant prescribing procedures for pain management are reviewed in end-of-life care services, ensuring that more effective systems of support and clinical supervision are put in place.
- Patients and the public are not put at risk by ensuring that all post-test contact systems within sexual health services have sufficient staff to ensure late or missing results are identified.
- A vision and strategy for end-of-life care services must be developed which sets out the objectives and plans for the service and reflects the local health economy needs. The strategy should be embedded in the organisation and shared widely with staff so they understand it.
- Leadership of end-of-life care services should be clarified and clearly articulated to all staff.
The CQC inspection team also found a number of areas of outstanding practice, including:
Inspectors saw that services in the trust’s community dental health services were good in all areas.
The staff on Bennion ward at Bradwell Hospital had introduced many dementia care initiatives, including: staff wearing theatre scrubs on night duty to mimic nightwear so that patients living with dementia were encouraged to sleep, night time care plans and a reminiscence room with pictures and books.
The trust recently set up a palliative care contact centre to improve care for patients needing palliative or end-of-life care. This drew on services from a range of local providers to meet individual patient needs.
Full reports for the trust will be published on CQC’s website today at the following link: www.cqc.org.uk/provider/R1E
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Find out more
Read reports from our checks on the standards at Staffordshire & Stoke-on-Trent Partnership NHS Trust