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Provider: NAViGO Health and Social Care CIC Good Also known as NAViGO

Reports


Inspection carried out on 14 Nov to 6 Dec 2017

During a routine inspection

Our rating of the provider stayed the same. We rated it as good because:

  • We rated the key questions of safe, effective, responsive and well-led as good overall and the key question of caring as outstanding overall. Our rating for Navigo took into account the previous ratings of services not inspected this time.
  • Our decisions on overall ratings take into account factors including the relative size of services and we use our professional judgement to reach a fair and balanced rating.
  • We rated well-led at the provider level as good.
  • We rated wards for older adults with mental health problems as outstanding and Rahrian Fields the eating disorders inpatient service as outstanding.
  • Navigo’s quality and patient safety strategy covered the next two years and aimed to strengthen the quality of patient care and ensure there was a clear strategic approach for quality governance .
  • The community interest company board and senior leadership team had the appropriate range of skills, knowledge and experience to perform its role.
  • Navigo met the fit and proper person requirement.
  • The Duty of Candour requirements were fully met by Navigo.
  • Engagement with staff, service users and carers around development of Navigo’s vision and values was exceptional and this was demonstrated throughout the whole organisation.
  • There was an overwhelming sense that all staff and service users were aware of all of the members of the community interest company board. They felt included in the organisation and they were able to be part of the decision making process.
  • In the 2016 NHS staff survey, Navigo was one of the best performing organisations.
  • Navigo has a sound approach to ensuring learning and change following ‘never ‘episodes, serious complaints and safeguarding incidents. The formulation and implementation of action plans was undertaken by a dedicated quality team.
  • Navigo had a safeguarding policy and procedure and their requirements were fully met under safeguarding.
  • Navigo was involved with the local sustainability and transformation partnership and the accountable care partnership, these plans aligned with Navigo’s strategy.
  • Navigo recognised staff success by staff awards and through feedback.

However:

  • The providers target rate for appraisal compliance was 100%. As at 31 August 2017, the overall appraisal rates for non-medical staff was 78%.
  • Navigo failed to meet its target of 35 days as detailed in their policy when responding to complaints.
  • The provider took a significant time to resolve staff grievances. One took six months and one took nine months to complete.
  • It is a legal requirement to publish a report annually stating what action has been taken to meet the public sector equality duty. Whilst an annual equality and diversity report had been produced and had been utilised to inform action within the organisation, it was not published at the time of inspection.


CQC inspections of services

Service reports published 15 February 2018
Inspection carried out on 14 Nov to 6 Dec 2017 During an inspection of Wards for older people with mental health problems Download report PDF | 304.14 KB (opens in a new tab)Download report PDF | 1.04 MB (opens in a new tab)
Inspection carried out on 14 Nov to 6 Dec 2017 During an inspection of Specialist eating disorder services Download report PDF | 304.14 KB (opens in a new tab)Download report PDF | 1.04 MB (opens in a new tab)
Inspection carried out on 14 Nov to 6 Dec 2017 During an inspection of Community-based mental health services for adults of working age Download report PDF | 304.14 KB (opens in a new tab)Download report PDF | 1.04 MB (opens in a new tab)
See more service reports published 15 February 2018
Service reports published 14 February 2017
Inspection carried out on 28 November 2016 During an inspection of Community-based mental health services for adults of working age Download report PDF | 212.09 KB (opens in a new tab)
Inspection carried out on 28 November 2016 During an inspection of Community-based mental health services for older people Download report PDF | 212.67 KB (opens in a new tab)
Service reports published 17 June 2016
Inspection carried out on 18 to 21 January 2016 During an inspection of Community-based mental health services for adults of working age Download report PDF | 268.13 KB (opens in a new tab)
Inspection carried out on 18 to 21 January 2016 During an inspection of Acute wards for adults of working age and psychiatric intensive care units Download report PDF | 287.38 KB (opens in a new tab)
Inspection carried out on 18 January - 21 January and 28 January During an inspection of Wards for older people with mental health problems Download report PDF | 349.43 KB (opens in a new tab)
Inspection carried out on 18 January - 21 January and 28 January During an inspection of Community-based mental health services for older people Download report PDF | 274.28 KB (opens in a new tab)
See more service reports published 17 June 2016
Inspection carried out on 28 November 2016

During a routine inspection

We rated the provider as good overall because:

  • Following our inspection in January 2016, we rated the provider as good for effective, caring, responsive and well-led.

  • During this most recent inspection, we found that the provider had addressed the issues that had caused us to rate safe as requires improvement following the January 2016 inspection.

  • The provider was now meeting Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

Inspection carried out on 18 January - 21 January and 28 January

During a routine inspection

We found that Navigo Health and Social Care CIC was performing at a level which resulted in a rating of good because:

  • We found that Navigo as a social enterprise had embraced the concept of patient involvement to its utmost with patients having an active voice in decision making as members of the community interest company. They also through their Tukes employment scheme work actively to engage patients to maximise their working potential to re-integrate patients with mental health problems back into the local community.

  • Laing Buisson present annual awards to organisations dedicated to innovation, effective practice and high quality delivery of healthcare in the United Kingdom. In March 2015, Laing Buisson awarded the specialist care award for Excellence in Dementia Care to the Konar team.

  • Restraint was only used once de-escalation techniques had failed. The service operated restraint elimination system practical effective control technique (RESPECT) training to de-escalate difficult situations training in response to managing the risks of patients.

  • The ward layout on all inpatient areas allowed staff to observe all parts of the ward, with clear lines of sight from the main lounge area.

  • None of the incidents of restraint were of prone restraint or resulted in rapid tranquilisation.

  • In the adults of working age community teams each patient had a care programme approach (CPA) assessment carried out at least annually and the east team had 95% completion with the west team having 93%.

  • We saw examples of staff following National Institute for Health and Care Excellence (NICE) guidance in the older adults inpatient service.

  • The Memory Services National Accreditation Programme (MSNAP) accredited the Navigo memory service. The memory service had achieved a rating of excellent for their previous reviews under the scheme

  • Navigo had amended their policies in order to adhere to the revised Mental Health Act (MHA) Code of Practice which was issued in April 2015

  • We received 173 comment cards from service users, carers and staff, an exceptional amount based on the size of the provider. Of these comment cards 152 were positive and 21 were negative.73 of the positive cards commented about the caring attitude of staff.

  • Konar Suite family and friends test had remained at 100% for over a year.

  • Navigo had been involved in the development and delivery of a joint training programme to support police officers understanding of personality disorder and Section 136 of MHA

  • Navigo had a membership of over 750 people made up of staff, people using the services and carers. All members had equal voting rights.

  • Low sickness and absence rates and reports from staff showed Navigo had a healthy culture. Staff throughout the organisation referred to Navigo as a family. Staff felt supported and were able to contribute and challenge decisions in their areas.

  • It was clear from senior management that the organisations greatest risk was financial sustainability.

However

  • The community memory service had some issues with control and storage of medication

  • The process in place at the Eleanor Centre for the disposal of the sharps box stored on the premises did not meet the requirements of the hazardous waste regulations

  • At the time of inspection the service did not have a full multidisciplinary team but had access to psychology and occupational therapy which underpinned the model of care for assessment, treatment and recovery.

  • On the acute services all staff had received their annual appraisal however the service had identified that’s some staff had not received their supervision as frequently as was expected. The service had implemented changes to address this

  • Navigo had provided training for staff on awareness of mental health and this included Mental Health Act awareness, however the provider has recognised that this training needs to be separate and has been addressed on their training action plan

  • There were some discrepancies in training figures that were provided to us. Navigo told us that this was due to the electronic system that collated training data.

  • We looked at seven complaint files. We found that all complaints were thoroughly investigated with balanced responses. Navigo’s policy on complaints stated that responses to complaints should be within 35 days. However, only one of the seven complaints met this target