England’s Chief Inspector of Hospitals has published his first report on the quality of the services provided by Sussex Community NHS Trust following an inspection by the Care Quality Commission.
Overall, the trust has been rated as “Good.” Its community health inpatient services have been rated as Requires Improvement for its safety, and its end of life care rated as Outstanding for how it responds to people’s needs.
Sussex Community NHS Trust delivers a wide range of community healthcare services from locations in West Sussex and Brighton and Hove with a total population of 1.1 million, care is provided to around 8,000 people a day.
A team of CQC inspectors, specialist advisors and people who have experience of using these types of services or know someone who has, spent four days at the trust in December during which they assessed the quality and safety of its care and spoke to patients and staff who work there. Based on these findings, CQC has published 5 reports that cover the services provided by the trust across its hospitals, in clinics, and in the community.
Full reports including ratings for all of the trust’s core services are available at: www.cqc.org.uk/provider/RDR.
At the time of CQC’s inspection, the trust had appointed a new leadership team, although many had only been in post a short time, including the Director of Nursing who had been in post for less than a year.
Inspectors observed that the trust’s board provided clear leadership to its staff and the culture of the organisation was positive across all of the services. Staff engagement was good and encouraged by the leadership group with a ‘Livingroom to Boardroom’ approach embedded into the trust’s strongly grounded values and vision.
Inspectors witnessed staff communicating with children with learning disabilities in a way that demonstrated strong communication skills and encouraged positive relationships, including the way in which children were asked for their opinions.. Inspectors saw evidence of outstanding care and treatment from the Midhurst Macmillan Unit, which provided care for patients with cancer. Following a review of services and consultation with patients and the wider health community, the trust identified that it was possible to provide hospital level care to people in their own homes. As a result this model of care had been endorsed by NHS England and is held as a model of good practice in publications from the King’s Fund. It is now being piloted in other trusts with the assistance of Macmillan Cancer Support.
CQC found recruitment and retention of staff was an issue for the trust, notably in health visitors, although there had been an increase in overall numbers of health visitors over the last 3 years there was still not sufficient numbers to meet the level of demand. The board did have a robust recruitment plan in place; however, it was acknowledged that staffing is particularly challenging in the north of the area due to the ability to commute into London.
Inspectors also identified a number of specific areas of good practice and some exceptional practice across the trust, including:
At Arundel Hospital, inspectors observed a “Major Incident Box”, which was stored in a prominent position within the staff room and contained everything staff would require to manage an incident. The Ward Manager briefed inspectors that this had been developed with the involvement of all levels of staff.
The Midhurst Macmillan specialist palliative care service team responsive to the needs of the patients in their care and achieved 85% of their patients being able to die in the place of their choosing.
Inspectors found many examples of good and innovative practice where passionate and committed staff actively promoted the health and wellbeing of their patients. Although understaffed, the teams worked hard to ensure that patient outcomes did not suffer. However all of the services were able to flourish because of the support and encouragement from the trust’s board.
The Chair had introduced an initiative called ‘Chat with the Chair’, in which she would go to locations across the trust and invite staff to drop-in and chat about anything on their mind.
The chief nurse has introduced “Sit and See” where staff would go to inpatient care locations within the trust to observe staff and patient interactions and use the learning to assess quality and guide improvement.
The trust encouraged and supported staff to take responsibility and ownership of their service. This encouraged innovation with staff taking pride in the service they offered. Staff from all levels in the organisation felt valued and listened to. They told us that the executive team actively sought their opinions and where possible acted upon them. Although caseloads and workloads were high staff across the organisation spoke of the positive working environments and told us how proud they were to work for the trust.
Ellen Armistead, Deputy Chief Inspector of Hospitals (lead for Community Health Services), said:
“Sussex Community NHS Trust provides good and some outstanding services to a large population. We found a committed and caring workforce that was meeting the needs of all those people safely and effectively.
“It was encouraging that the staff we met held such a positive view of the recent improvements and were proud to work for the trust. The executive team, with the support of all staff must continue to work hard to deliver improvements we require on behalf of all of their patients.”
“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. The trust has told us they have listened to our inspectors’ findings. We will return in due course to check that the improvements needed have been made.”
Ends
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Find out more
Read reports from our checks on the standards at Sussex Community NHS Trust.