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Hounslow and Richmond Community Healthcare NHS Trust Requires Improvement says CQC

6 September 2016
  • Media,
  • Hospitals

The Chief Inspector of Hospitals has rated Hounslow and Richmond Community Healthcare NHS Trust as Requires Improvement overall - after an inspection by the Care Quality Commission.

A team of inspectors, including specialist advisors and experts by experience visited the trust during March 2016 as part of CQC’s programme of comprehensive inspections of community health services.

The trust provides a range of community based services in the London boroughs of Hounslow and Richmond, which includes: inpatient rehabilitation services; community district nursing; health visiting; physiotherapy; nutrition and dietetics; health promotion; speech and language therapies and occupational therapy. It also provides some specialist services such as audiology, neuro-rehabilitation, continence services and continuing care.

CQC has rated the trust as Requires Improvement in all areas: for safety, being effective, caring, responsive and well-led. To read the full report and ratings for all key services click on the link below

High vacancy rates, particularly in community nursing, were impacting on the service. This placed further pressure on existing permanent staff including under reporting of incidents and the take up of training. The nursing leadership team were relatively new in post and had made meaningful progress however, staffing remained an area for further improvement.

Inspectors found that although the majority of beds at Teddington Memorial Hospital were designated as being for patients requiring rehabilitation, an increasing number of patients living with dementia and those requiring continuing care were being admitted and were sharing the same ward space. This meant that staff spent a lot of time caring for patients with challenging behaviour and caused a great deal of distress and disruption to the rehabilitation patients. There were delays in transferring these patients to a more suitable setting due to their complex needs.

CQC found that patients’ needs were not always met at night with noisy staff and patients shouting, lights on and loud music playing at midnight. Patient feedback indicated that this was not an isolated event and that the wards were often very noisy at night.

As a result of the inspection the trust must:

  • Reduce staffing shortages and the high turnover of staff and unsustainable caseloads for practitioners.
  • Reduce the delays in moving patients with dementia to a more suitable setting.
  • Ensure patients are able to rest and sleep on wards.
  • Ensure patients are always treated with dignity and respect.

However inspectors did find that patients consistently achieved positive outcomes following rehabilitation care and treatment at Teddington Memorial Hospital, despite its Inadequate rating. They also found that care at the trust was provided in a compassionate way in the majority of instances.

Professor Edward Baker, Deputy Chief Inspector of Hospitals, said:

“We rated Teddington Memorial Hospital, the trust’s inpatient unit, as Inadequate. The hospital was increasingly being asked to admit patients outside of its admission criteria because of pressures on the local acute trusts. This was proving a challenge to adequately staff and to provide positive patient experiences for all those receiving care and treatment there.

“As a priority the trust needs to ensure that there are always enough staff to meet patients' needs. There was evidence of pressure on existing permanent staff, delays in incident investigation and the under reporting of incidents.

“The trust needs to make sure patients’ rights are always upheld and verbal consent is obtained before undertaking tasks such as washing and dressing.

“However, we saw several areas of good practice including the trust’s audiology service performed consistently well and was recognised nationally with accreditation under the Royal College of Physicians’ Improving Quality in Physiological Diagnostic programme. The trust’s paediatric immunisation team performed well in a London-wide benchmarking analysis, and came second amongst all trusts for delivery of paediatric flu jabs.

“We also found that services for children and young people at the trust were effective, caring, responsive and well-led.”


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Last updated:
29 May 2017

Notes to editors


Hounslow and Richmond Community Healthcare NHS Trust provides community health services for more than 500,000 people living across the two London boroughs it serves. It employs more than 1,000 staff, the majority of which are clinicians including nurses and allied health professionals such as physiotherapists, speech and language therapists, dietitians, podiatrists and occupational therapists. It officially became a NHS trust on 1 April 2011 following the merger of community health services in Hounslow and Richmond.


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.