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Provider: Sussex Community NHS Foundation Trust Good

Inspection Summary


Overall summary & rating

Good

Updated 30 July 2018

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

  • Safe, effective, caring, responsive and well led were good.
  • Community inpatients was good overall. Safe had improved from requires improvement to good. Caring had improved from good to outstanding.
  • Community dental services were good for safe, effective, caring, responsive and well led. This was the first time this service had been inspected.
  • Sexual health services were good for safe, effective, caring, responsive and well led. This was the first time this service had been inspected.
  • In rating the trust, we took into account the current ratings of the three services not inspected this time.
Inspection areas

Safe

Good

Updated 30 July 2018

Our overall rating of safe stayed the same. We took into account the current ratings of services not inspected this time. We rated it as good because:

  • All trust services 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. Service managers increased staffing when patients needed more attention, including when they needed one-to-one care.
  • Community inpatients had improved to good from requires improvement.
  • Staff continued to be clear about their roles and responsibilities with regards to safeguarding patients.
  • Areas we visited were visibly clean, staff demonstrated good infection control practices and procedures.

Effective

Good

Updated 30 July 2018

Our overall rating of effective stayed the same. We took into account the current ratings of services not inspected this time. We rated it as good because:

  • In all services we visited, staff continued to demonstrate care was given in line with best practice. This was confirmed with regular audits carried out by local services and the trust.
  • Staff in all areas we visited were competent to perform their roles. Attendance at appraisals was good and staff told us the process enable them to develop their skills further.
  • Community inpatient services used a variety of patient reported outcome measures to measure the effect of treatment interventions.

Caring

Good

Updated 30 July 2018

Our overall rating of caring stayed the same. We took into account the current ratings of services not inspected this time. We rated it as good because:

  • We found during this inspection, care delivered in community inpatient services was outstanding.
  • Staff consistently put patients at the centre of everything they did.
  • Patients gave us numerous examples across the inpatient locations of when care had exceeded the standards expected from staff.
  • Staff routinely performed tasks, which would not routinely be expected as part of their role or were outside of their working hours to ensure patients received the best quality care and outcomes.

Responsive

Good

Updated 30 July 2018

Our overall rating of responsive stayed the same. We took into account the current ratings of services not inspected this time. We rated it as good because:

  • The trust continued to work closely with commissioners and other external bodies to make sure it planned and delivered services according to the needs of local people.
  • Staff throughout the organisation worked to ensure individual needs were met. Patients and carers with additional needs were supported.
  • The trust treated concerns and complaints seriously and investigated them. We saw lessons learned were shared with staff and examples of change as a result of complaints.

Well-led

Good

Updated 30 July 2018

Our overall rating of well led stayed the same. We took into account the current ratings of services not inspected this time. We rated it as good because:

  • We found there were clear lines of leadership and accountability from operational staff to the board level directors. Staff at all levels were clear in their roles and responsibilities in the delivery of good quality care. Leaders were dedicated, experienced and staff told us they were visible throughout the organisation.
  • The vision and strategy of the trust was clear, staff were proud of the values and demonstrated them in their delivery of care.
  • The trust had an open and honest culture which reflected throughout all levels of the organisation.
  • The management of risk was embedded throughout the organisation. There were clear systems and processes in place to identify, manage and reduce risk.
  • Staff and the public engaged with the trust effectively using a variety of methods. The trust had been nominated for an award in the staff engagement category this year.
  • Managers and staff embraced an improvement culture and tried hard to improve the quality and sustainability of services.
Checks on specific services

Community health sexual health services

Good

Updated 30 July 2018

  • There were systems and processes in place to report, investigate and learn from incidents.
  • People who used the service were safeguarded from the risk of abuse and had their human rights respected and upheld.
  • Staff received an appropriate level of training to undertake their roles. We found suitable numbers of staff to meet people’s needs.
  • The service had appropriate policies, processes and pathways that reflected national guidance and best practice. There was a clinical audit lead and sufficient audit plan which was used to measure quality and improve clinical outcomes.
  • Care was delivered by kind, professional staff who ensured people were treated with dignity and respect. The service received high levels of complimentary feedback and very low levels of complaints. Comments and concerns were taken account of and used to improve the service.
  • There was a good leadership team that was visible, supportive, and approachable. Staff told us they felt valued and were proud of the team spirit and patient first ethos.

However,

  • We found the integrated governance processes resulted in delays to renewing policies and procedures.
  • Morley Street drop in clinic was struggling with the demand and scale of services required by the local community. Whilst the clinical waste was stored in locked waste bins, the waste area was not secure. This included the area for sharps disposal. We acknowledge the service was aware of this risk and had received planning permission to build a secure area and were awaiting a ‘license to change’ from the land lord.

Community dental services

Good

Updated 30 July 2018

  • Staff reported incidents appropriately. Incidents were investigated, shared, and there was evidence of lessons learned.
  • Staff understood their safeguarding responsibilities and could describe the safeguarding policies and procedures. Staff had up to date safeguarding training at the appropriate level.
  • Medicines were stored, handled and administered safely.
  • Equipment was well maintained and fit for purpose.
  • Staffing levels were appropriate and met patients’ needs at the time of inspection.
  • Patients’ individual care records were comprehensively written in a way that kept people safe. Relevant information was recorded appropriately and staff had access to relevant details before providing care.
  • Standards of cleanliness and hygiene were generally well maintained. Systems effective in preventing and protecting to prevent and protect people from a healthcare associated infection.
  • Mandatory training was provided for staff and compliance met or exceeded the trust targets in most topics.
  • Staff had the necessary qualifications and skills they needed to carry out their roles effectively. Further training and development opportunities were available for staff.
  • Appropriate systems were used to respond to medical emergencies.
  • Patients’ needs were assessed and their care and treatment was delivered following local and national guidance for best practice.
  • The service followed effective evidence based care and treatment policies which were based on national guidance.
  • There was evidence of good multidisciplinary working with staff. Teams and services worked together to deliver effective care and treatment.
  • During the inspection, we saw and were told by patients, that all staff working in the service were kind, caring and compassionate at every stage of their treatment.
  • People were treated respectfully and their privacy was maintained in person and through the actions of staff to maintain confidentiality and dignity.
  • Staff were sensitive to the needs of all patients and were skilled in supporting patients and young people with disabilities and complex needs. We saw there were systems to ensure that services were able to meet the individual needs, for example, for people living with dementia and learning disabilities.
  • Staff involved patients and those close to them in aspects of their care and treatment. Information about treatment plans was provided to meet the needs of patients.
  • There was an effective system to record concerns and complaints about the service. Complaints were reviewed and actioned appropriately with a view to improving patient care.
  • Staff told us that they felt supported by their immediate line managers and that the senior management team were visible within the department.
  • There was a very positive and forward looking attitude and culture apparent among the staff we spoke with.

However:

  • Staff raised concerns with us regarding the information technology (IT) system used to record patient information and notes in all locations of the community dental services. The clinical records did not always provided a consistent, reliable and effective system for the recording and retention of patient information
  • The Lancing Health Centre and Chailey Heritage Clinical Services did not have dedicated decontamination rooms. Staff told us there was no definitive action plan, including a date when this would be addressed.

Community health inpatient services

Good

Updated 30 July 2018

  • There were systems and processes in place to keep patients safe from harm.
  • Safety had improved overall and managers closely monitored staffing issues and addressed them as required. Medicines management and audit had improved.
  • Records were being simplified, so all patient information was held in one location.
  • Staff were competent to deliver care in line with best practice and demonstrated with regular audit.
  • Staff delivered outstanding care to patients. We saw numerous examples where staff had gone the extra mile. Staff consistently demonstrated patients were at the centre of everything they did.
  • Services were delivered in line with the needs of the local population. Patients individual needs were considered and catered for.
  • The service was well led by dedicated managers who were driven to provide the best quality service. The culture of the service in all areas we visited was one of teamwork to deliver high quality care. Staff clearly demonstrate the trust’s values.

However:

  • We identified problems at Crawley hospital with regard to referral to mental health services and monitoring and administrating pain relief.
  • Advice on how to complain was not consistently displayed throughout all locations we visited.