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Chief Inspector of Hospitals finds significant improvements at North Staffordshire Combined Healthcare NHS Trust

21 February 2017
North Staffordshire Combined Healthcare NHS Trust
  • Mental health community services,
  • Mental health hospital services

England’s Chief Inspector of Hospitals has rated the services provided by North Staffordshire Combined Healthcare NHS Trust as Good following an inspection by the Care Quality Commission in September.   

North Staffordshire Combined Healthcare NHS Trust provides a range of inpatient and community mental health services to adults, older people and children. The CQC inspected the core services provided by the trust for five days.

The trust was inspected in September 2015 when it was rated as Requires Improvement overall. Inspectors found considerable improvements had been made at the latest inspection where the care was rated as Good overall.

Inspectors rated the care provided by staff to be Good regarding whether services were effective, caring, responsive and well-led and rated it as Requires Improvement regarding whether services were safe

CQC’s Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said:

“Overall, North Staffordshire Combined Healthcare NHS Trust provides good care to the large population that it serves. The trust can be proud of many of the services that it manages.

“Since our inspection in September 2015, the trust has made significant improvements to the quality to care plans and risk assessments. Documentation consistently showed a collaborative approach to care that involved staff, patients, carers and families.

“Staff throughout the trust displayed a caring attitude towards people who used services. We saw several examples of staff showing kindness, empathy and putting peoples’ needs first. Feedback from patients, carers and families was also very positive and staff ensured that delivery of care was carried out in a co-productive manner.

“The trust board has become more settled and effective which helped to ensure governance systems were embedded.

“Nursing staff spoke very highly of the new substantive director of nursing. Staff told us that they now felt they had strong nursing leadership at a senior level in the organisation who was committed to clinical and leadership development.

“There were, however, several areas where improvements were needed.The trust has told us they have listened to our inspectors’ findings and we are confident that the executive team, with the support of their staff, will work to deliver these improvements on behalf of all of their patients. We will return in due course to check on the progress that they have made.”

The reports highlight several areas of good practice, including:

  • The trust had done impressive work around deaf and hard of hearing patient groups; particularly the deaf café, British sign language (BSL) training for staff and effectively addressing communication needs.
  • The vascular wellbeing team manager had published a paper on the use of a camera for people with short term memory problems. They have since worked with the local clinical commissioning group (CCG) to incorporate the use of text messaging service and were working on an ‘app’ for patients’ with early onset dementia and mild cognitive impairment.
  • The care home liaison team held multi-disciplinary meetings at five care homes. GPs and families reported that this worked well. The input of physiotherapy into care homes with patients at risks of falls had reduced hospital admissions.
  • The community child and adolescent mental health services (CAMHS) had run a ‘CAMHS in schools’ project with special schools for the past 11 years. They had developed a pilot to introduce the model into mainstream schools.
  • A military veteran’s drop-in service had been established. Managers allocated one member of staff two days a week to develop this. It has succeeded quickly and, at the time of our inspection, had a caseload of 42 patients.

Inspectors said that the trust must improve in some areas, including:

  • The provider must ensure that its rapid tranquilisation policy accurately reflects current prescribing guidance from national institute for health and care excellence (NICE) guidelines. Staff must record and have a consistent approach to the use of rapid tranquillisation as well as understanding its risks.
  • The provider must ensure that their process of sending out monthly letters to young people on waiting lists from initial assessment to treatment is followed.
  • Staff must always record any prescribed medication that is given, omitted or refused on patients’ prescription charts.
  • The provider must continue to work towards seeing young people within 18 weeks from the point of referral.


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Last updated:
29 May 2017

Notes to editors

The trust provides the following core services:

  • Wards for older people with mental health problems
  • Substance misuse treatment services.
  • Wards for people with learning disabilities
  • Long stay/rehabilitation mental health wards for working age adults
  • Children and adolescent mental health wards
  • Mental health crisis services and health based places of safety
  • Community-based mental health services for older people
  • Specialist community mental health services for children and young people
  • Community-based mental health services for adults of working age
  • Community mental health services for people with learning disabilities

The trust provides services across North Staffordshire to a population of 464,000 people. It operates from one hospital site (Harplands Hospital) and approximately 30 community-based premises. Harplands Hospital opened in 2001 and holds most of the inpatient units.

The Care Quality Commission will present its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

Under CQC's inspection model, the Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical experts, specialist inspectors and trained members of the public. Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

Since 1 April 2015, providers have been required by law to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily. This should be done within 21 days of publication of their inspection report.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.