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Provider: The Christie NHS Foundation Trust Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 12 October 2018

Our rating of the trust stayed the same. We rated it as outstanding because:

We rated effective, caring, responsive and well-led as outstanding, and safe as good. We rated four of the trust’s seven services as outstanding and three as good. In rating the trust, we took into account the current ratings of the four services not inspected this time.

We rated well-led for the trust overall as outstanding.

  • The culture across all the services we inspected was extremely positive. Staff at all levels were very proud of their organisation and the work they did.
  • The trust ensured that there were sufficient numbers of staff who possessed the right skills and experience deployed at all times.
  • The trust valued patients consistently as individuals; we saw and heard examples of staff going the extra mile to meet the needs of patients and their families.
  • The services provided care and treatment in line with national guidance and evidence based practice. The hospital was a leader in the field of cancer care and pioneered new initiatives and procedures.
  • The trust services were tailored to meet the needs of individual people and delivered in a way to ensure flexibility, choice and continuity of care.
  • The trust leaders were prominent and respected in cancer treatment and procedures. The trust provided expertise and guidance for other members of the healthcare economy. They worked in collaboration with leaders of cancer care locally and nationally.
  • The trust engaged with people well. There were many engagement opportunities for staff and the public. These opportunities were varied and substantial. There was evidence of consistently high levels of constructive engagement with staff and people who use services.

However:

  • The processes for ensuring effective learning from incidents was not always robust.
  • Some audit systems within the surgical directorate were not robust enough to identify potential safety issues.
Inspection areas

Safe

Good

Updated 12 October 2018

  • The trust had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
  • Staff had received up-to-date training in safety systems, processes and practices.
  • Risks to people who used services were assessed, monitored and managed. These included signs of deteriorating health and medical emergencies.
  • The service controlled infection risk well. All environments we saw were visibly clean and tidy.
  • Staff kept appropriate records of patients’ care and treatment.
  • The service managed patient safety incidents well in most areas.
  • Medicines were managed appropriately in most instances.

However:

  • The processes for ensuring effective learning from incidents was not always robust.
  • Some audit systems within the surgical directorate were not robust enough to identify potential safety issues.
  • The management team had not fully implemented the Local Safety Standards for Invasive Procedures (LocSSIPs) based on the National Safety Standards for Invasive Procedures (NatSSIPs) as recommended by the National Patient Safety Agency.

Effective

Outstanding

Updated 12 October 2018

Our rating of effective stayed the same. We rated it as outstanding because:

  • Care and treatment was provided in line with national guidance and evidence based practice. The trust was a leader in cancer care and pioneered new initiatives and procedures which were later adopted as best practice elsewhere.
  • The trust reported positive outcomes and reduced complications.
  • The continuing development of the staff’s skills, competence and knowledge was recognised as being integral to ensuring high-quality care. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills, and share best practice.
  • There was evidence of effective multi-disciplinary working. Teams from different disciplines worked together to create bespoke tailor made surgical and treatment plans for patients. This reduced complications and multiple surgeries and treatments and increased survival rates and quality of life measures.

Caring

Outstanding

Updated 12 October 2018

Our rating of caring stayed the same. We rated it as outstanding because:

  • Staff were exceptionally kind and caring and provided holistic patient centred care.
  • We saw and heard about examples when staff had gone the extra mile to ensure their patients felt their experience was the best they could provide and the patient was at the centre of care.
  • Feedback from people who used the service was continuously positive. Patients felt their care was delivered with exceptional kindness and patience.
  • Patients, their relatives and carers opinions, needs and involvement was highly valued by staff and all were included and considered in the planning and delivering of care.
  • Patients told us they felt they were partners in the planning and delivery of care rather than having decisions and plans imposed on them. They felt empowered to contribute to decisions based on the attitudes and inclusivity of the staff they came into contact with.
  • The trust provided a substantial and effective network of emotional support for patients.

Responsive

Outstanding

Updated 12 October 2018

Our rating of responsive stayed the same. We rated it as outstanding because:

  • The services were anticipated, planned and delivered in a way that met the needs of local people and the needs of those who used the service from the wider population.
  • The facilities and processes were designed with the involvement of and with the needs of service users in mind. The way the services were delivered evolved and was adapted in response to the changing needs of patients and their relatives.
  • Specialist bespoke surgical treatments were developed for patients with unusual, complex, advanced cancers. Tailor made treatment plans were developed in collaboration with other disciplines to increase efficacious outcome and survival rates, reduce complications and lengths of stay and the need for multiple interventions and improve quality of life.
  • Access to the service was effective and timely. Access could be tailored to meet the needs of individual patients and their needs.
  • Specialist nurses and complementary therapists created a personalised service for anxious or phobic patients and those with cognitive impairments or individual needs.
  • There was an enhanced supportive care clinic (ESC) at the hospital that provided multi-disciplinary supportive care for the prevention and management of the adverse effects of cancer and its treatment.
  • Spiritual support was available and staff were respectful of the cultural needs of families.

Well-led

Outstanding

Updated 12 October 2018

Our rating of well-led stayed the same. We rated it as outstanding because:

  • We found compassionate, inclusive and effective leadership at all levels. Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care.
  • Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. There were high levels of staff satisfaction across all groups. The culture was extremely positive and staff were very proud of their organisation and the work they did.
  • The trust and services had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community. Strategies and plans were aligned with plans in the wider health economy and the direction of cancer services nationally.
  • The engagement of staff and the public was varied and substantial.
  • Leaders demonstrated a strong ethos of collaboration and working together for the needs of the patient.
  • The services had many prominent and respected leaders in cancer treatment and care. They provided expertise and guidance for other members of the healthcare economy. They worked in collaboration with leaders of cancer care locally and nationally.
  • Staff across the services were aware of risks and managed these well. Ward and departmental managers were responsible for managing, reviewing and updating risks using risk registers for clinical and non-clinical areas.
  • The trust engaged well with patients, staff, the public and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.

However:

  • Within the surgical directorate, learning from incidents was not always robust, audits and quality assurance processes were not always effective and the management team had not fully implemented the Local Safety Standards for Invasive Procedures (LocSSIPs).