Suffolk County Council

Updated 5 June 2017

Suffolk County Council provided a range of health services for children and young people aged 0-19 years, and their families. This was both universal and targeted community based healthcare and services included: health visiting, school nursing, special school nursing, named nursing for safeguarding children, children in care nursing, community learning disability nursing, enuresis and family nurse partnership services. These services were delivered from a range of community settings including health centres, children’s centres, schools and service user’s homes.

The service operated from Endeavour House in Suffolk and services were available to all children, young people and their families living in the county of Suffolk, with exception to people living in the Waveney region whereby another provider operated.

Overall the service employed 30 senior, service and team managers, 200 registered nurses, health visitors and school nurses, 78 family support practitioners, children’s health advisors and behavioural support assistants, and 78 business support assistants.

The service budget for 2016 to 2017 was £9.2 million pounds.

The service first registered with the Care Quality Commission (CQC) in March 2011 to provide the following regulated activities:

• Nursing care
• Treatment of disease, disorder or injury

There was a Registered Manager for the service who had been in post since November 2014.

Demographic data about the Suffolk region:

• 7,960 live births in 2014
• 22.6% of the population in Suffolk were children and young people
• 13.2% of school children were from a minority ethnic group
• The health and wellbeing of children in Suffolk was generally better than the England average
• Infant and child mortality rates were similar to the England average
• The level of child poverty was better than the England average
• The rate of family homelessness was better than the England average
• Life expectancy was better than the England average

(Public Health England, 2016).

During our inspection we spoke with 39 members of staff including health visitors, school nurses, support staff, specialist nurses, the registered manager and other managers and senior managers. We visited two child health clinics where we spoke with six people who had used the service and we reviewed the healthcare records of 20 service users. We examined a number of documents the service had sent us including some of their policy and procedures and audit results. We also contacted stakeholders who worked with the service, such as other healthcare providers, and asked for feedback from them about the service.

Our inspection team consisted of two CQC Inspectors, one of which had a background in health visiting. 

Updated 5 June 2017

Updated 5 June 2017

We did not rate the service. We found:

• Safety performance over time was good, the quality of healthcare records was high, equipment was serviced appropriately and environments were safe and suitable for purpose.
• Despite low staffing numbers in some areas of the service provision, with planned future budget cuts, senior managers were taking appropriate action to sustain services. Staff we spoke too stated that despite some staffing level concerns they felt they were able to provide safe care.
• Service users had their needs thoroughly assessed, care goals identified and care plans were in place accordingly.
• Breastfeeding rates were above target and improving overtime and blood spot screening for eligible babies was 100%.
• Staff were competent and access to additional training was very good.
• We saw evidence of effective multidisciplinary (MDT) working and collaborative pathways for service users.
• We observed staff treat people who used the service with dignity, respect and compassion.
• Services were planned and delivered which met the needs of local people, including those with different needs and in vulnerable circumstances.
• People could access the service in a timely way and there were examples of innovation in terms of a text messaging system used for school aged children.
• Complaints were low and handled effectively.
• Staff spoke highly of their seniors stating that they were visible, approachable and supportive, and described a culture within the service whereby the child was paramount, a culture of candour and working together.
• Service users and staff had opportunity to engage with the service on varying levels, and there were numerous examples of innovation, improvement and sustainability to service provision.

However there were also a number of concerns relating to the safety, effectiveness and governance of the service that needed to be addressed. We found:

• A lack of staff training and policy relating to the duty of candour.
• Insufficient formal arrangements were in place for the ordering and supply of medicines.
• The majority of service documents we reviewed, including policies and patient leaflets, did not contain either date of issue or a review date, and not all staff were able to access the service’s new policy and procedure database.
• Some of the Health Child Programme (HCP) outcomes were not being met due to a lack of staff.
• Performance data for the school nursing service was insufficiently captured and monitored.
• Some data was missing from employment records such as the date when pre-employment checks were carried out.