East Cheshire NHS Trust

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs. At our last assessment we rated this key question as good. At this assessment the rating has remained as good.

This meant people’s needs were met through good organisation and delivery.

Care was person centred, patients were treated as individuals, and their views were considered in all elements of their care. Patients were confident in the care being provided and felt able to raise concerns or complaints should they feel the need to.

The service was working to improve waiting times and reduce the numbers of patients who did not attend appointments, through quality improvement projects and the use of technology. The service expected that this would help to improve access to services, reduce the waiting times for appointments and ensure clinic times were well utilised.

Information provided to patients was clear and understandable, staff supported patients to understand information where necessary. At locations where care was provided, posters and leaflets about health and social wellbeing visible for patients. Although information was all provided in English, staff confirmed they were able to access translation services as necessary.

The service worked closely with the wider community to help address health inequalities within the community, to ensure equity in access and experience.

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.

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients were treated as individuals. Patients and carers felt their opinions were listened to when making decisions about their care and that staff considered their individual needs. Patients also told us that staff discussed their care plans with them and explained any jargon to them, to ensure they understood them clearly.

The care plans we reviewed included the views of patient and their carers. Staff were able to respond promptly to patient requests, for example in the bladder and bowel service, if referrals were received before 1.30pm continence products could be provided next day. The team also had access to urgent supplies in the office for patients out of hours, over the weekend or on the end-of-life pathway.

We observed how staff discussed individual patients during handovers. Staff considered each patient and their family’s needs, and potential referrals that may be required. Staff were knowledgeable about their patients and their community.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Patients were supported to have choice and control over their own care. In the Congleton and Holmes Chapel Care Community, a lower limb pathway for leg ulcers encouraged and supported patients to take ownership of their wound care. This pathway was completed in partnership with primary care, district nurses and tissue viability. They had a monthly leg MDT meeting to support joint working and an increase in patients self-caring, and a reduction in leg ulcer waiting times.

Teams were working to address waiting times. The average wait times for community nursing clinics and the respiratory nurse had been improving. While the community nursing clinics were not yet at the local clinical standards, there had been a reduction in the three months prior to the inspection. The respiratory clinics waiting times were now below the local clinical standards.

The therapy teams were using a variety of methods to reduce their waiting lists. In the musculoskeletal teams, a waiting list validation exercise had been completed which saw a reduction in the waiting list by 50%. The validation process was funded by the local Integrated Care Board in May/June and highlighted that referrals were not always appropriate and signposting for support needed to be reconsidered. The waiting lists in neuro outpatients had also decreased from 25 weeks to 6 weeks, following successful recruitment to occupational therapist posts.

The bladder and bowel team had taken action to improve the did not attend appointment rates, through using a text-based reminder system. The team had seen a reduction in wasted clinic time as a result.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service displayed information leaflets in English at all sites. Clinics had a variety of posters on subjects including cancer support, voluntary groups and local services.

There were no displayed information leaflets in other languages, however staff told us that they could access translations, and translator services if required.

The Knutsford District nurses had a quality improvement project in care homes and with care agencies that used QR codes that linked to videos on the equipment. These videos showed carers how to correctly use the equipment and reduce the risk of pressure sores. The videos reduced the issue of language barriers or miscommunication.

At the Knutsford District and Community Hospital, there was also a quality board display with information about the team, out of hours services and patient feedback.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The trust undertook regular patient feedback surveys across the directorates including community services. The most recent local survey for pulmonary rehabilitation completed from April – June 2025 showed patients were happy with the service, and responses had improved on previous years. A Friends and Family Test survey was also completed in the same time frame for community nursing, rehab and therapy, and specialist services. All services had over 90% positive responses, and the comments highlighted the professional attitudes of staff and the quality of the explanations regarding their treatment.

Patients told us they were confident to raise concerns with teams and knew how to make a complaint should they wish to.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Episodes of care and treatment were provided in a variety of locations across the trust, and patients we spoke to did not raise any concerns regarding access to services. Locations were accessible for patients with mobility issues; most clinics were on the ground floor or had access via lifts.

The pulmonary rehab team offered initial assessments in a variety of locations, to increase accessibility. For patients who would be unable to participate in group sessions of exercise and education due to being housebound or having difficulty with communication, 1 to 1 sessions were available at home. However, as part of the pulmonary rehab local surveys, patients who were able to attend group sessions did raise that there were sometimes issues in getting to some locations due to distance and the cost of taxis.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff had a clear understanding of patients’ individual needs. Teams delivered high quality care and worked collaboratively across the service, utilising the skills of nurses, therapists, advanced clinical practitioners and social workers.

Through the care communities and the Cheshire East Blueprint 2030, which operated throughout the East Cheshire footprint, staff worked to address inequalities in access and outcomes. The Blueprint 2030 focused on three key areas: healthy households, empowering households to live well for longer, healthy neighbourhoods, connecting communities to access services and support, and health and care services, bringing services together to better facilitate urgent and planned care.

Staff had training in Equality, Diversity and Human Rights, and the completion rates were over 85% for all bands.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment. We saw in records that do not attempt cardiopulmonary resuscitation (DNACPR) had been discussed where applicable and team leaders reviewed this as part of their audits of care records.

Staff created personalised care plans, that were discussed with patients and carers, to ensure their wishes and opinions were considered.

For patients who were nearing the end of their life, staff discussed their care and supported families to understand the future of their relative’s care and treatment.

Staff provided patients with information for post discharge, which enabled them to access exercises that would continue to support their rehabilitation when they were no longer appropriate for service and had been discharged.