East London NHS Foundation Trust

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Our overall rating of caring has stayed the same. Community Health Services for adults were rated as good.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People consistently reported feeling cared for and that they mattered. Care and support exceeded expectations and staff went the extra mile. Staff always treated colleagues from other organisations with kindness and respect.

Patients and carers consistently spoke positively about how the district nursing and specialist teams treated them. 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 in Bedfordshire CHS, 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 anticipated where they may be experiencing discomfort or distress and prevented it happening in the future. 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.

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.

We observed staff always treating people with care, support and respect. Staff were discreet when caring for patients and spoke about people thoughtfully and compassionately during meetings. They demonstrated a good understanding of people’s individual needs, and considered people’s emotional and social needs as important as their physical needs. In Tower Hamlets CHS, a relative told us the service was considerate of their loved one’s cultural needs.

Staff maintained confidentiality and only shared information with other agencies when it was necessary to keep people safe. Staff also felt empowered to raise concerns about disrespectful, discriminatory or abusive behaviour, and were confident that managers would listen and take action.

Staff had a proactive approach to treating people as individuals and made sure people’s care, support and treatment met their needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff adjusted their approach to support patients where needed and made reasonable adjustments to ensure services were accessible. This included ensuring disabled people could access premises and offering appointments away from service bases when required, so patients could access care equitably.

Staff ensured patients could access information about their treatment, local services, their rights and how to complain. One family told us that staff focused on their loved ones needs and gave valuable information relating to health and well-being, including practical and respite information.

However, information leaflets were not always available in languages spoken by patients. The trust recognised this and was working to improve access to translated materials. Staff told us they could access interpreters and signers when needed, and teams included staff who spoke several languages, including Bengali.

Staff ensured patients had access to appropriate spiritual support. We observed staff discussing people’s spiritual needs and received consistent feedback from patients that staff understood and respected spiritual practices and religious holidays.

Staff also demonstrated an understanding of the emotional and social impact of people’s care, treatment or condition on their wellbeing and on those close to them.

Staff promoted people’s independence, so they knew their rights and had choice and control over their own care, treatment. and wellbeing.

People who used services and those close to them were active partners in their care. Staff were highly motivated to support patients to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. For example, in the heart failure clinic in Bedfordshire CHS, we observed a nurse explaining care and support options clearly and compassionately to a patient and their partner, helping them to maintain their independence.

Records showed that staff proactively involved families and carers appropriately in patients’ care and treatment. Staff used paper records kept in patients’ homes to communicate effectively with carers and family members, ensuring continuity and shared understanding of care.

Staff and managers told us that people’s personal, cultural,socialand religious needs were reflected in care records. For example, district nursing visits were scheduled to avoid prayer times where this was important to the person. This showed respect for individual beliefs and preferences.

The service provided a range of appropriate equipment to support and maximise people’s independence and outcomes from care and treatment. The service also ran quality improvement projects to empower people to self-manage long-term conditions, including supporting patients to manage their diabetes and administer their insulin safely and independently.

Staff listened to and understood people’s needs, views and wishes. Staff acted to minimise any discomfort, concern or distress.

Patients’ needs, views, wishes and comfort were a priority. Staff anticipated these needs promptly to minimise any avoidable discomfort, concern or distress. Feedback from patients showed that staff were reliable, attentive and responded quickly when concerns were raised, helping people to feel safe and well‑supported in their homes.

Therapy support workers in the urgent community response teams stepped in when carers urgently needed a break, enabling people to remain at home rather than move into respite care. Care navigators within the teams supported patients and families with social and housing needs.

Staff were alert to people’s immediate needs and took time to observe, communicate and engage with them. They responded appropriately and respectfully to people’s wishes.

Staff quickly recognised when people required urgent help or support and used appropriate tools and technology to assist. Patients told us about occasions when staff contacted them later in the evening to provide additional support.

The trust cared about and promoted the wellbeing of staff, and supported and enabled them to always deliver person centred care.

Staff felt respected, supported and valued. Staff felt positive and proud about working for their team and the wider trust. The trust supported a diverse workforce and enhanced career development and satisfaction.

Staff had access to support for their physical and emotional wellbeing through an occupational health service. In the South locality team (Bedfordshire CHS), staff raised concerns about limited parking, which sometimes meant they had to wait up to 30 minutes to park before briefly entering the office to collect equipment. Since the inspection, the trust has informed staff of additional parking available at nearby council sites and planned to include this information in its induction programme to improve awareness and use of these spaces.

Staff also raised concerns about poor system connectivity when working away from the office, and managers took action to resolve this.

In Tower Hamlets CHS, managers improved staff wellbeing by addressing day-to-day operational issues. Senior leaders worked with local community partners identify places where staff could take comfort breaks while working in the community.

The trust recognised staff successes within the service. In Tower Hamlets CHS, staff won an award for improving service user experience within the advance care planning pathway, and in Newham and Bedfordshire CHS staff achievements were also acknowledged locally.