• Organisation
  • SERVICE PROVIDER

Provide Community Interest Company

This is an organisation that runs the health and social care services we inspect

Overall: Outstanding read more about inspection ratings
Important: Services have been transferred to this provider from another provider

All Inspections

23 Jan to 6 Mar 2019

During an inspection of Community health inpatient services

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
  • Staff kept detailed patients’ records and these records were clear, up-to-date and easily available to all staff providing care.
  • The service followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right dose at the right time.
  • Staff assessed patients to ensure they received enough food and drink to meet their needs and improve their health. They used special nutritional and hydration assessments when necessary.
  • The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
  • Staff treated patients with compassion and respect. Privacy and dignity was maintained when treating the patient. Staff also provided emotional support to patients, relatives and those close to patients to minimise distress.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.

However, we also found:

  • A lack of a formal checking process for defibrillators and oxygen cylinders.
  • Not all clinicians could access to the incident reporting system
  • Whilst the service was providing pain relief to patients, pain scores were not being formally recorded in patient records in a systematic way.

12-15 December 2016

During an inspection of Community end of life care

We rated end of life care as good overall because:

  • Openness and transparency about safety was encouraged.
  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses and where incidents had been raised actions were taken to improve processes.
  • Safeguarding was given sufficient priority. Staff had a good understanding of how to protect patients from abuse. Staff described what safeguarding was and the process to follow if they suspected a patient was at risk of avoidable harm or abuse.
  • Arrangements to minimise risks to patients were in place with measures to prevent falls, malnutrition and pressure ulcers. We observed staff followed good infection and prevention control practices.
  • Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately.
  • Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so that patients were safe. Syringe drivers were mostly maintained and used in accordance with professional recommendations.
  • End of life care was planned and delivered in line with best practice guidance. Care and treatment was planned and delivered in a personalised and holistic way and care plans took into account patients health and social care needs.
  • Our observation of practice, review of records and discussion with staff confirmed there were effective multidisciplinary team (MDT) working practices. Staff worked collaboratively to understand and meet the range and complexity of patients’ needs.
  • Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
  • We observed a holistic person-centred approach to patient care. Patients were treated with compassion, kindness, dignity and respect.
  • Without exception, feedback from patients and relatives was positive.
  • Without exception, staff were not only committed to providing sensitive care to patients, but also for the well-being of their families.
  • Staff provided emotional support for patients and their families, and signposted them to other sources of support where appropriate.
  • As part of the care provision for children with palliative care needs, the provider delivered respite care services for Essex Palliative Integrated Care Children’s Respite Service (EPIC). EPIC was part of Provides children’s specialist services business unit and sat within the children’s specialists services.
  • The provider engaged with external organisations and the local community to ensure the services met the needs of patients and those close to them who required end of life care.
  • Patients could access the service in a timely manner that suited their individual needs.
  • Data provided by the trust showed the end of life care service received one complaint between November 2015 and November 2016 specific to the service.
  • The leadership, governance and culture mostly promoted the delivery of high quality person-centred care.
  • The locality leads, clinical nurse specialists and community staff were able to articulate the purpose of their service, to provide care and support for patients in their last year of life, and their role within the integrated locality team. All staff, including very senior managers understood the importance of end of life care.
  • There were good governance structures in place for end of life care through the integrated governance structure.
  • The lead for end of life care was visible, and there was good local support and leadership for end of life care. Staff had confidence in their managers to ensure training and expertise knowledge was available to improve end of life care experiences for patients and those who were close to them.
  • There was good public and staff engagement throughout end of life care services.

However;

  • There was no safety performance dashboard related to end of life care. This meant there was no visual aid to advise staff. A dashboard is a toolset developed by the National Health Service (NHS) to provide clinicians with relevant and timely information they need to inform daily decisions that improve the quality of patient care. The toolset gives clinicians access to data that is being captured locally, in a visual and usable format. The safety dashboard displays local relevant safety information alongside relevant national data.

21-23 January 2014

During a routine inspection

Central Essex Community Services C.I.C. is a provider of integrated health and social care and provides a broad range of community services to more than 1.9 million people in Essex, Cambridgeshire, Peterborough, and the London boroughs of Waltham Forest and Redbridge.

Whilst the provider HQ is based at St Peter’s Hospital in Maldon, Essex, it provides over 50 services to children, families and adults within a wide range of community settings. This includes a community ward in each of three hospitals (St Peter’s in Maldon, Braintree Community Hospital and Halstead Community Hospital), community clinics, schools, nursing homes and primary care settings, as well as within peoples own homes.

We chose to inspect Central Essex Community Services C.I.C. as part of the first pilot phase of the new inspection process we are introducing for community health services

We found that Central Essex Community Services C.I.C. was providing safe care and saw some good examples of caring and compassionate care.  Staff spoke with passion about their work, felt proud and understood the values of the organisation.

Front line staff work hard to ensure individualised and person centred care, tailored to best meet the needs of patients, families and carers. People from all communities could access services and effective multidisciplinary team working, including inpatient and community teams, ensured people were provided with care that met their needs, at the right time. However, strategic planning and development of some services lacks the direct consultation with and feedback from patients, families and carers.

The Board and senior managers had oversight of the reported risks and had measures in place to manage reported  risks.  However, the risk management systems are immature and pose a risk to the Board’s ability to have a clear oversight of risks to quality in the organisation.  Action is required to enhance staff ability and awareness to identify and consider serious incidents, incidents, near miss incidents and risks and what they should do with that information.

We found some good examples of innovative practice not least the care given to patients by the children's speech and language therapists. The service had won a national innovation award for contribution to their profession. 

In 2012/13, the provider surveyed people using each of its services with the results reported to be generally favourable. However, as the survey was for Central Essex Community Services C.I.C. only, it is not possible to benchmark the results against other similar organisations.