- SERVICE PROVIDER
East London NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 2 October 2026
Contents
Ratings - Community health services for adults
Our view of the service
We assessed Community Health Service Adults from 20 to 22 January 2026.
We carried out a short notice announced inspection of community health services for adults as part of our continual checks on the safety and quality of healthcare services. We visited community health services for adults in Tower Hamlets, Newham and across Bedfordshire. We visited 7 district nursing teams, 2 tissue viability/leg ulcer services, 3 urgent community response teams and 3 community therapy teams.
We spoke to 20 patient’s, 44 carers and relatives. We reviewed 29 patients’ care and treatment records. We attended home visits with district nurses and physiotherapists, including observing medication administration. We carried out a tour of the environment at each site we visited. We observed handover meetings, allocations meetings, risk meetings, and safety huddles. We spoke with 83 staff members including a clinical director, clinical leads, community matrons, nurses, non-medical prescribers, physiotherapists, occupational therapists, care navigators, health care assistants, tissue viability nurses and diabetes specialist nurses.
We had previously inspected community health services for adults in September 2016. As a result of that inspection, we had rated the safe domain as requires improvement. The trust was in breach of regulation 12, as staff did not maintain appropriate patient care and treatment records. We had rated the effective, caring, responsive and well led domains as good. Our overall rating was good.
At this inspection our ratings changed. Our rating for safe improved, this domain was rated as good and there was no longer a breach in regulation. Ratings for effective, caring, responsive and well led stayed the same and were rated as good. Our overall rating stayed the same, and the service was rated as good.
People were protected from avoidable harm. Staff recognised and managed risks well, including risks associated with pressure damage, deterioration and safeguarding. Care records supported safe practice, and systems for reporting, learning from and responding to incidents were well embedded. Since the last inspection, improvements had been made and the service was no longer in breach of regulation.
Care and treatment was effective. Staff assessed people’s needs thoroughly and worked well together across teams and with partner organisations to deliver joined-up care. This helped people to avoid unnecessary hospital admissions and supported timely discharge from acute services.
People who used services and those close to them were active partners in their care. Staff treated people with kindness, compassion and respect. People consistently told us they felt listened to, involved in decisions about their care and supported to maintain their independence. The caring culture across the services was a strength, with staff consistently meeting people’s emotional, cultural and social needs.
Services were responsive to people’s needs. Care was person-centred, and staff acted promptly when people’s condition changed. Waiting times were monitored, urgent referrals were prioritised appropriately and missed visits were rare. Staff had introduced improvements in response to feedback from patient’s and carers.
The service was well led. Leaders were visible, approachable and understood the challenges facing community services. Governance arrangements provided reasonable assurance of safety and quality, and partnerships with acute trusts, primary care, ambulance services and social care supported coordinated care. Staff felt supported and valued, although ongoing pressures from increasing demand and workforce challenges meant leaders needed to continue focusing on staff supervision, capacity and sustainability.
However,
Although supervision compliance was improving, it remained below the trust target during the inspection, and the trust needed to continue to strengthen systems to ensure all staff received regular supervision.
Information leaflets were not always available in languages spoken by patients. The trust recognised this and was working to improve access to translated materials.
People's experience of this service
Patients and carers spoke positively about the district nursing and specialist teams. We spoke with 20 patients and 44 carers and relatives, who described staff as “brilliant”, “very friendly and lovely” and “very considerate, knowledgeable and professional.” Many people told us staff went above and beyond, referring to them as the “best team” and “so dedicated”. People said they trusted staff and felt more confident in their mobility and treatment plans because of the support they received. One patient told us they would not know what to do without staff “coming to me, reassuring and always smiling.” Another patient described staff as “efficient, friendly, caring, hardworking and witty… everything is absolutely perfect”. A relative also told us the “service is so good, and we recognise how lucky we are.”
People told us staff provided clear information, advice and emotional support when they needed it. Staff directed patients to other services when appropriate and supported them to access these. Patients described how staff shared information with their GP, and we observed staff explaining to a patient and their partner the purpose of their medicines and why they were needed.
Patients and carers felt staff responded quickly and efficiently to their needs, particularly when they were in pain or distress. Most people said staff helped them to manage their pain well. For example, a carer told is that a physiotherapist supported their loved one with exercises alongside medication to help relieve pain. People said they felt safe and supported, including during evening visits. During a home visit, a patient and their family member told us the “service has been fantastic” and said the number of falls had reduced because of the support provided.
Patients and carers had regular opportunities to give feedback in ways that met their needs, including through annual satisfaction surveys, participation forums and monthly focus groups. Feedback was largely positive. In December 2025, 58 patients shared feedback about Bedfordshire community health services for adults, with all rating their overall experience as good or very good.