You are here

Provider: University Hospitals of Derby and Burton NHS Foundation Trust Good

Inspection Summary


Overall summary & rating

Good

Updated 6 June 2019

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

  • We rated safe, effective, caring, responsive and well led as good.
  • We rated ten of the core services we inspected at this inspection good overall and four as requires improvement.

Inspection areas

Safe

Good

Updated 6 June 2019

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

  • Staff understood how to protect patients from abuse and services worked well with other agencies to do so.
  • The majority of services, controlled infection risk well. Staff kept themselves, equipment and the premises clean. They mostly used control measures to prevent the spread of infection.
  • Whilst actual versus planned staffing levels were not always met. Services had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

Effective

Good

Updated 6 June 2019

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

  • Services provided care and treatment based on national guidance and evidence of its effectiveness.
  • Managers monitored the effectiveness of care and treatment and used the findings to improve them.
  • Staff gave patients enough food and drink to meet their needs and improve their health.
  • Staff assessed and monitored patients regularly to see if they were in pain.
  • Staff of different kinds worked together as a team to benefit patients.

Caring

Good

Updated 6 June 2019

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

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

Responsive

Good

Updated 6 June 2019

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

  • The trust planned and provided services in a way that met the needs of local people.
  • Services took account of patients’ individual needs.
  • Services treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Well-led

Good

Updated 6 June 2019

We rated it as good because:

  • Managers at all levels in the trust had the right skills and abilities to run a service providing high-quality sustainable care. The trust had a senior leadership team in place with the appropriate range of skills, knowledge and experience.
  • The trust had a vision for what it wanted to achieve and workable plans to turn it into action. Using an external engagement platform, the vision, values and strategy of the trust had been developed in collaboration with staff, people who use services, and external partners.
  • The executive board were committed to promoting a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Throughout this inspection and through our observation of the trust we saw cooperative, supportive and appreciative relationships among the executive team. The executive team worked collaboratively, shared responsibility and resolved conflict quickly and constructively.
  • The trust had nine of 10 key indicators equal to or above the national average for similar trusts in the 2018 NHS Staff Survey.
  • The trust engaged with patients, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively. People’s views and experiences were gathered and acted upon to shape and improve the services and culture.
Checks on specific services

Community health inpatient services

Good

Updated 6 June 2019

This was our first inspection since the acquisition, so we cannot compare our ratings with previous inspections.

We rated it as good because:

  • Patients were protected from avoidable harm.
  • There were systems, practices and processes to keep people safe and safeguarded from abuse.
  • Staff had all the information they needed to deliver safe care and treatment.
  • Medicines were managed well and in accordance with policies.
  • Care and treatment was provided based on best available evidence, and care outcomes were monitored.
  • Staff had the skills, knowledge and experience to deliver safe and effective care.
  • Teams worked well together and engaged with local organisations to provide good care.
  • Patients were treated with kindness, dignity and respect.
  • Patients received personalised care according to their needs.
  • There was effective leadership. Leaders has the capacity and capability to deliver high quality, sustainable care.
  • There were clear, effective processes for managing risks, issues and performance.

Community urgent care services

Requires improvement

Updated 6 June 2019

This service had not previously been inspected under our community health methodology we are not therefore able to compare to past ratings of this service.

We rated it as requires improvement because:

  • We did not see evidence that robust safeguards were in place to ensure that patients who required immediate attention had an assessment by a clinician when waiting for longer than one hour to be seen. There was a first contact protocol in place to identify patients who needed seeing urgently, however the effectiveness of this was not monitored or audited.
  • We reviewed patient group directions on the Samuel Johnson Minor Injuries Unit and found them to be incomplete and inconsistent. The service were taking action to put this right.
  • Incidents and near miss events were not being reported in line with trust policy. This had previously been identified as a concern, but staff provided examples of incidents that had occurred and not been reported. Incident reporting numbers were low.
  • We did not see evidence of effective governance, including assurance and auditing systems or processes in the minor injuries units.

However:

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they provided examples of how they applied it.
  • The service controlled infection risk well and systems were in place to maintain standards of cleanliness and hygiene. Both minor injuries units were visibly clean and tidy, with completed cleaning schedules in place.
  • The service had access to a range of clinical pathways and assessment tools based on national guidance and we saw these in use.
  • Staff were caring and treated patients with compassion.
  • Both minor injuries units met the standard for admitting, transferring or discharging patients within four hours of attending and staff worked across services to coordinate people’s involvement with families and carers.
  • Staff were supportive of each other and proud of the service they provided.