Adelaide Health Centre/Western Community Hospital

Solent NHS Trust provides community and specialist healthcare services to a population of over a million people living in Southampton, Portsmouth, South East and South West Hampshire. Some services extend across the whole of Hampshire, including sexual health services and community dental services.

Solent NHS Trust HQ is based at Adelaide Health Centre and this report relates to community services provided trust wide, and is not limited to those provided at the health centre. Trust wide services are provided from over 120 different locations including community and day hospitals, as well as outpatient and other settings within the community such as health centres, children’s centres and service users homes.

During our visit we held focus groups with a range of staff across community health services. These included ward nurses, health care assistants, community nurses, community matrons, health visitors, school nurses, allied health professionals, doctors, dentists and administrative staff. We observed how people were being cared for, talked with carers and/ or family members and reviewed personal care or treatment records of patients.

Overall we found that community services were safe. Staff understood the importance of reporting untoward incidents and were confident and willing to raise concerns. The Trust had systems for collating and investigating incidents and there was evidence of improvements arising and some sharing of learning across services.

Most people working at the service said that they felt there were enough staff and the Trust was taking a proactive approach to check that there were enough staff to keep people safe and meet people’s needs. However some district nurse teams and the rapid response team in Southampton were finding it hard to meet demand and the recruitment of staff was ongoing. We found the leadership and sharing of productive and effective ways of working across the Southampton and Portsmouth community teams could be improved.

Generally there was good access to services and these were responsive to the differing needs of patients. An excellent service was provided to homeless people in Southampton, and the community dental services provided exceptional care to patients, children and young people with special needs. But we found there was insufficient capacity at some busy sexual health clinics. There was a risk that patients turned away from these clinics would not receive timely treatment, or may not receive treatment at all.

Staff used pathways of care to treat patients, based on nationally agreed best practice. There was good multi-disciplinary and multi-agency team work taking place. We found examples of innovative practice and excellent care which enabled patients, children and young people to receive care at home, or close to home, and avoid admission to an acute hospital.The Children’s Outreach Assessment and Support Team (“COAST”) was particularly notable.

We found a high level of patient satisfaction across community services. The majority of people commented on the caring and compassionate approach of staff across the organisation. Staff were highly motivated and committed and treated people as individuals. We observed that patients were treated with dignity and respect. End of life care and in particular the Portsmouth specialist palliative care team was notable.

We found examples of good leadership and staff felt they were well supported by their managers. Staff were aware of the trust’s objectives and values and felt well-led by all levels of the organisation. Many said they had good supervision, training and development opportunities.