Chief Inspector of Hospitals rates Royal Devon and Exeter NHS Foundation Trust as Good

England’s Chief Inspector of Hospitals has rated Royal Devon and Exeter NHS Foundation Trust as Good following an inspection by the Care Quality Commission.

The trust has been rated as Outstanding for providing services that are caring, and Good for providing services that are effective, responsive and well led, while safety was rated Requires Improvement. Urgent and emergency services and critical care at Wonford Hospital were both rated Outstanding. The full reports on all core services are available here.

Professor Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said:

“When we inspected Royal Devon and Exeter NHS Foundation Trust, we found the care was exemplary throughout the trust. We found the care in the emergency department and in critical care services that was outstanding.

“Staff engagement is very good. There is a long established and supportive leadership with a clear vision and set of values that staff understand and work towards. There is a positive culture throughout the trust. All of the staff we met on this inspection spoke positively about ensuring that patients received a consistently high quality service and experience.

“We have identified some areas that require improvement but I am confident that Royal Devon and Exeter NHS Foundation Trust will build on this particular inspection to ensure that this high standard continues. Trust staff should be proud of this achievement.”

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts visited Wonford Hospital and the Mardon Neuro-Rehabilitation Centre over a period of four days in November 2015. There were also two unannounced inspections.

CQC found that across the trust staff displayed a clear commitment to providing patients with high quality care and treatment. Staff treated patients with dignity and respect, and inspectors were told by patients that staff went out of their way to help and support them. Inspectors witnessed exemplary care being given on many wards. In addition, the trust sought feedback from patients and their relatives and used the feedback to continuously improve the care delivered.

Outcomes for people who used the emergency department were consistently better than expected when compared with similar services. National audits showed that performance in the treatment of sepsis (a life-threatening infection of the blood) and paracetamol overdose was particularly good.

The trust had a strong safety culture and providing safe, harm-free care was considered a priority for staff at all levels. Learning from incidents was widely shared across the trust and staff recognised the importance of reporting incidents to ensure patient safety.

Inspectors identified a range of areas of outstanding practice, including:

Ambulance service crews had an agreement with the emergency department that they would radio ahead to tell staff when they were bringing a patient with a suspected broken hip. This gave nurses time to inflate a pressure relieving mattress for the trolley on which the patient would be treated. In this way, pressure ulcers would be prevented but X-rays could still be carried out without moving the patient.

The care being provided by staff in the critical care unit went beyond day-to-day expectations. Inspectors saw patients’ beds being turned to face windows so they could see outside with staff positively interacting with all patients and visitors with evidence of staff going out of their way to help patients. Patients and visitors gave overwhelmingly positive feedback.

Royal Devon and Exeter NHS Foundation Trust is one of only three trusts in the country with recognition in achieving the Gold Standards Framework for end of life care, with three wards accredited and one deferred. Plans to extend the gold standard to further wards demonstrated an outstanding commitment by ward staff and the specialist palliative care team to end of life care.

Inspectors identified some concerns with the confidentiality of records. Not all records were kept secure to prevent unauthorised access. The supply or administration of medicines should also be in line with trust policies and best practice.

On 10 February CQC 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.

Ends

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