East London NHS Foundation Trust has been rated as Outstanding overall by the Care Quality Commission after an inspection in June. It is one of the first NHS providers of mental health services to be given the top rating by inspectors.
The trust was rated Outstanding for being caring, responsive and well-led. It was rated Good for being safe and effective.
ELFT was first established as a mental health trust covering East London (City and Hackney, Newham and Tower Hamlets). Over the years the remit of the trust has broadened. In 2011 it started to provide community services in Newham.
The trust also provides psychological therapies in Richmond and children and young people’s speech and language therapy in Barnet. The trust also has a mother and baby unit at the Homerton which receives referrals from across the South-East. In April 2015 the trust gained responsibility for mental health services in Bedfordshire and Luton.
ELFT has invested over the previous two years in a wide scale quality improvement programme. This has been embraced by staff. The methodology has successfully encouraged innovation and improvement which CQC inspectors were able to see throughout the inspection. There was a genuine passion to ensure that the services provided are the best possible.
The trust had an ongoing programme to improve the safety of the buildings where patients received care. In the last year they had invested £12.3m to improve the physical environments especially in Luton and Bedfordshire.
In March 2016, 7.2% of staff posts were vacant. This was very low for the London region. The trust had a robust values-based recruitment process in place to maintain the numbers and quality of staff joining the trust. Over 500 staff had been offered posts in Luton and Bedfordshire since the trust took over managing these services.
The trust ensured that staff assessed the physical health of all patients. They had developed a single page physical health assessment proforma which included all the key health parameters. They were also innovative in promoting people’s physical health. London community health teams provided patients with facilities to check their weight and blood pressure before outpatient appointments.
The trust also provided good physical healthcare to people being cared for in the trust’s wards. For example, patients in the forensic services had access to a substance use support service which offered educational and support groups. Also young people at the Coborn Centre had access to sexual health services.
Staff provided holistic care and made every effort to get to know and understand people and meet their needs. This was done in a non-judgemental way that respected people’s individual choices.
Patients and carers were very involved in preparing their care plans. They were also fully involved in ward rounds and review meetings.
Patients needing access to the acute care pathway (i.e. hospital beds) were receiving an outstandingly responsive service. The trust was managing bed occupancy on the trust acute mental health wards to a continuously high standard. Beds were available for patients who needed admission and the focus of work was on supporting patients with their discharge. This work started as soon as they arrived on the ward.
The home treatment teams acted as the gate-keepers for the acute beds to ensure that all other options had been exhausted before an admission was required. These teams were very responsive and would see urgent referrals within four hours (or in Bedfordshire within two hours in A&E). The London teams had a target of seeing 80% of new referrals within 24 hours, which they were meeting for 85% of the patients referred. Patients across the trust had access to a crisis line that operated throughout the night and, when needed, there was a duty emergency team. During the day there was a dedicated line for patients being supported by the home treatment team. This was answered by an experienced nurse who could arrange additional visits if needed.
To read the full report click on this link: www.cqc.org.uk/provider/RWK
Dr Paul Lelliott, Deputy Chief Inspector (and lead for mental health) said:
“East London NHS Foundation Trust is well led with a visionary board and senior leadership team who have created an open culture that welcomes innovation. There are hard-working and enthusiastic staff throughout the organisation who enjoy their work and are committed to improving services.
“Staff were genuinely engaged in the work of the trust. Many staff had worked at the trust for a number of years and said they would not want to work anywhere else. They knew the senior staff in the organisation, felt it was non-hierarchical and said they could raise concerns or ideas in the knowledge that they would be taken seriously.
“There was a genuine passion to ensure that the services provided are the best possible. Staff worked with patients and their carers to ensure they were partners in their care. Patients were supported to express their wishes. They were active participants in all the meetings where their care was discussed. But more than this, patients were actively involved in the running of the trust.
“The trust staff understood the importance of supporting patients with their physical as well as their mental health. The trust recognised and celebrated the diversity of the patients and staff and worked to meet the needs of people using the services.
“Although we have rated the trust Outstanding overall, our inspection has identified some areas where further improvement can be made. We expect the trust to continue its journey of continuous improvement and we will work with the trust to build on the findings of our inspection.”
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