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Provider: The Dudley Group NHS Foundation Trust Requires improvement

On 12 July 2019, we published a report on how well The Dudley Group NHS Foundation Trust uses its resources. The ratings from this report are:

  • Use of resources: Requires improvement  
  • Combined rating: Requires improvement  

Read more about use of resources ratings

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 July 2019

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

  • Corbett Hospital was rated as inadequate overall, and in one service safe and well-led were rated as inadequate.
  • Russells Hall Hospital was rated requires improvement overall, in two services, safe was rated as inadequate and one service as inadequate for well led.
  • Community services were rated good as overall.

Our full inspection report summarising what we found and the supporting evidence appendix containing detailed evidence and data about the trust is available on our website – www.cqc.org.uk/provider/RNA/reports.

Inspection areas

Safe

Inadequate

Updated 12 July 2019

Our rating of safe went down. We rated it as inadequate because:

  • Diagnostics at Corbett and Russells Hall hospital and urgent and emergency safe domain were rated as inadequate.
  • Surgery at Russells Hall and Corbett, maternity, children and young people and outpatient department at Russells Hall and Corbett safe domain were rated as requires improvement.
  • Critical care unit and end of life care at Russells Hall and the community safe domain were rated as good.

Effective

Good

Updated 12 July 2019

Our rating of effective improved. We rated it as good because:

  • Surgery at Russells Hall and Corbett, critical care unit, maternity, children and young people, end of life care at Russells Hall Hospital and Community Effective domain were rated as good.
  • Urgent and emergency care effective domain were rated as requires improvement.

Caring

Good

Updated 12 July 2019

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

  • End of Life Care in the community and surgery at Russells Hall Hospital caring domain were rated as Outstanding.
  • Urgent and Emergency Care, critical care unit, maternity, children and young People, end of Life Care at Russells Hall Hospital, outpatient department at Russells Hall hospital and Corbett, diagnostics imaging at Corbett and surgery caring domain were rated as good.
  • Diagnostics Imaging at Russells Hall and Guest were rated as requires improvement.

Responsive

Requires improvement

Updated 12 July 2019

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

  • Children and young people, urgent and emergency care, critical care unit and diagnostic imaging at Russells Hall responsive domain were rated as requires improvement.
  • Surgery at Russells Hall and Corbett, maternity, end of life care at Russells Hall Hospital and community, outpatient department at Russells Hall and Corbett, diagnostics imaging at Corbett responsive domain were rated as good.

Well-led

Requires improvement

Updated 12 July 2019

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

  • Diagnostics Imaging at Russells Hall and Corbett Well Led domain were rated as inadequate.
  • Urgent and emergency care, maternity, children and young people, outpatient department at Russells Hall and Corbett Well Led domain were rated as requires improvement.
  • Surgery at Russells Hall and Corbett, critical care unit, end of life care at Russells Hall and community Well Led domain were rated as good.
Checks on specific services

Community health services for adults

Good

Updated 18 April 2018

We rated it as good because:

  • The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.
  • The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
  • We saw excellent innovative multidisciplinary team working. Staff of different disciplines worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
  • Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
  • The trust planned and provided services in a way that met the needs of local people.
  • Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
  • The trust was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation.

However

  • Community staff were not fully compliant with mandatory training or appraisal rates.
  • Whilst we were confident patients were receiving person centred care, we found patient care plans were generic and not person centred.
  • People could not always access services when they needed it. Waiting times for treatment were not always in line with good practice.

Community end of life care

Good

Updated 12 July 2019

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

  • The leadership team had planned for enough nursing staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

  • Staff were provided with mandatory training in key skills. Compliance was good, and education, training, learning, reflection and learning was promoted, supported and embedded.

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care. An improved electronic recording system with a view to becoming paperless meant that there were ongoing improvements in record accessibility.

  • The team provided care and treatment based on national guidance and evidence of its effectiveness. Managers monitored and checked practice to make sure staff followed guidance. Staff consulted and adhered to NICE guidelines which meant patients received evidence-based care.

  • Managers monitored the effectiveness of care and treatment and used the findings to improve them. They compared local results with those of other services to learn from them.

  • Staff of different disciplines worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care. Joint working and collaboration with external stakeholders was fully embedded in the work carried out to support patients and their families.

  • The team consistently cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Staff provided emotional support to patients to minimise their distress. There were are a range of supportive services available to patients and their families while using services and following bereavement.

  • The team involved patients and those close to them in decisions about their care and treatment.

  • The team took account of patients’ individual needs. Interpreters were accessible for patients who did not speak English. There were champions who had received additional training to ensure good quality care across the board. Patients, the carers and staff could access mental health teams and a psychologist for support.

  • People could access the service when they needed it. Staff responded to referrals to treatment promptly and in line with good practice. There were 7-day a week, 24 hour a day services available and accessible specialist support out of hours.

  • Managers at all levels in the trust had the right skills and abilities to run a service providing high-quality sustainable care. Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

  • The trust used a systematic approach to continually improve the quality of its services and safeguarding high standards of care by creating an environment in which excellence in clinical care would flourish.

  • The trust was committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.

However, we also found:

  • Despite support to recruit a locum consultant, the service did not have enough medical staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.