North East London NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff were competent and knowledgeable. They were proactively supported to acquire new skills, use their transferable skills and share best practice.

Staff obtained consent from patients before carrying out any treatment. Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff consistently recorded alerts in the patient record system and had up to date records for ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNA CPR) where this was appropriate. Managers and staff carried out a comprehensive programme of regular audits to check compliance and improvement over time to support the delivery of care.

Teams had relevant information promoting healthy lifestyles and support in their area. The Barking and Dagenham diabetes team received a ‘diabetes education and self-management for ongoing and newly diagnosed’ (DESMOND) award, recognising the delivery of high-quality education to people living with, or at risk, of type 2 diabetes.

However, in some of the London teams, a small number of patients reported a language barrier between them and the staff providing their care. They could not always understand each other as staff did not always book interpreters for appointments and had to rely on relatives.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The trust planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff were competent and knowledgeable. They were proactively supported to acquire new skills, use their transferable skills and share best practice. Staff were required to complete competency assessments before undertaking tasks independently and additional training was tailored to meet the individual needs of staff.

Staff could access additional and bespoke training to support their learning and development in using devices such as syringe drivers. Staff’s skills, competence and knowledge was recognised as being integral to ensuring high quality care. Staff and leaders had up to date knowledge in relation to good practice and standards, relevant to their service. Staff followed up-to-date policies to plan and deliver high quality care in line with national guidance.

The trust monitored the frequency and quality of staff supervision and appraisals. Managers made sure staff attended team meetings or had access to meeting minutes when they could not attend. Staff told us they were supported to gain further qualifications relevant to their role.

The trust planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff were competent and knowledgeable. They were proactively supported to acquire new skills, use their transferable skills and share best practice. Staff were required to complete competency assessments before undertaking tasks independently and additional training was tailored to meet the individual needs of staff.

Staff could access additional and bespoke training to support their learning and development in using devices such as syringe drivers. Staff’s skills, competence and knowledge was recognised as being integral to ensuring high quality care. Staff and leaders had up to date knowledge in relation to good practice and standards, relevant to their service. Staff followed up-to-date policies to plan and deliver high quality care in line with national guidance.

The trust monitored the frequency and quality of staff supervision and appraisals. Managers made sure staff attended team meetings or had access to meeting minutes when they could not attend. Staff told us they were supported to gain further qualifications relevant to their role.

The trust always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Teams had positive relationships with external health and social care stakeholders. Staff worked effectively with NHS trusts, social care and primary care clinicians to deliver high quality services.

Staff worked collaboratively to ensure patients received high levels of care. Staff told us that referrals from local hospitals did not always include accurate referral information. Staff were engaging with local acute hospitals to improve this. Staff were also working with partner organisations to improve discharge information.

Information was shared between teams and services to ensure continuity of care. District nursing teams had monthly meetings that included community matrons where peoples care and treatment was reviewed and discussed. The district nurses described effective multidisciplinary and integrated team working between tissue viability, diabetic services and leg ulcer teams.

District nursing staff arranged as needed calls with GPs to discuss their individual patients. Tissue viability nurses (TVN) also offered information sharing meetings with GP surgeries.

The trust supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Teams had relevant information promoting healthy lifestyles and support in their area. Staff comprehensively assessed each patient’s health and provided support for any individual needs to live a healthier lifestyle.

The Barking and Dagenham diabetes team received a ‘diabetes education and self-management for ongoing and newly diagnosed’ (DESMOND) award, recognising the delivery of high-quality education to people living with, or at risk, of type 2 diabetes.

The trust routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Teams used data to understand and improve services.

Managers and staff carried out a comprehensive programme of regular audits to check compliance and improvement to support the delivery of care.

Each team had an audit schedule. Individual clinicians led on audits which included infection and prevention control, environment, catheter care and care and treatment records.

Managers told us they monitored team performance through supervision and oversight of audit findings.

The trust told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gained consent from patients for their care and treatment in line with legislation and guidance. Staff recorded consent in the patients’ records.We observed good practice around obtaining consent during appointments. For example, a tissue viability nurse on a home visit sought consent from the person receiving care to speak to their spouse about their treatment and progress. Care plans had details about people’s capacity. Staff had access to up-to-date policies that were in line with best practice guidance relating to consent and Mental Capacity Assessment.

Staff supported patients to make informed decisions about their care and treatment. Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.

Staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards. Where Mental Capacity assessments and best interest decisions had been completed, they were person-centred, decision specific and signed by the relevant parties. When patients could not give consent, staff made decisions in their best interests, and took into account the patients’ wishes, culture and traditions, as well as the views of any family or carers.

Staff consistently recorded alerts in the patient record system and had up to date records for ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNA CPR) where this was in place. Records contained information about where to find a copy of the DNA CPR if this was needed. Easy access to this information meant staff could respect the wishes, the comfort and dignity of patients.