Chesterfield Royal Hospital NHS Foundation Trust

Updated 29 May 2020

CQC temporarily suspended all routine inspections on 16 March 2020 to support and reduce the pressure on health and social care services during the COVID-19 pandemic. CQC, as well as providers, want to be able to prioritise keeping people safe during this time.

This inspection was already underway at the time of the suspension and therefore could not be completed in the usual way. This report includes the findings from the completed service level inspections, but the well-led inspection was not completed.

Updated 29 May 2020

We have not updated trust-level ratings following these core service inspections because we were not able to complete the trust-level well-led inspection. This is due to suspension of routine inspections during the COVID-19 pandemic. Refer to the previous inspection report for the detailed findings on which the ratings are based.

Updated 29 May 2020

Updated 29 May 2020

Updated 25 January 2019

Our rating of this service improved. We rated it as good because:

• The service had suitable premises and equipment and looked after them well.
• The psychiatrists prescribed within guidance and any off-licence prescribing was done in discussion with the pharmacy team.
• Records were clear, up-to-date and available to all staff providing care.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
• The service had enough staff with the right qualifications, skills, training and experience to provide the right care and treatment.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
• The service monitored the effectiveness of care and treatment and used the findings to improve them.
• The service made sure staff were competent for their roles. Staff received regular managerial and clinical supervision.
• There was good multi-disciplinary working within the team and good joint working with external professionals.
• Staff always had access to up-to-date, accurate and comprehensive information on young peoples ‘care and treatment. All staff had access to an electronic records system that they could all update.
• Staff understood their roles and responsibilities under the Mental Capacity Act 2005. They knew how to support young people who lacked the capacity to make decisions about their care.
• Staff showed compassion and warmth towards young people. Feedback from young people and their parents confirmed that staff treated them well and with kindness.
• Staff involved young people and those close to them in decisions about their care and treatment and took account of young peoples’ individual needs.
• The service planned and provided services in a way that met the needs of local people.
• The service had managers at all levels with the right skills and abilities to run a service providing high quality sustainable care.
• Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.
• The service engaged well with young people, staff and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.
• The service was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation.

However:

• Caseloads were high, particularly for core CAMHS staff and psychiatrists.
• Mandatory training rates were low.
• IT issues were impacting on staff’s ability to do their job effectively.
• Technology was not being used to support the care and engagement of young people.
• Appraisal rates were low.
• Confidentiality could be compromised as it was possible to hear from the waiting area, reception staff responding to phone calls.
• Waiting lists were long for Attention Deficit Hyperactivity Disorder assessment, Autism Spectrum Disorder assessment and Cognitive Behavioural Therapy and EMDR (Eye movement desensitisation and reprocessing).