Calderdale and Huddersfield NHS Foundation Trust

On this page

• 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

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

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.

The Friends and Family survey (FFT) from the previous 12 months showed 96% positive feedback. 2,118 patient comments were received and 2,068 were positive. Patients repeatedly described staff as friendly, respectful and supportive. Observation of care delivery showed that patients understood their care options and were supported to make informed decisions about their treatment and care.

The care records we reviewed addressed patients’ physical, mental, and social needs, including those linked to protected characteristics under the Equality Act.

Services were designed to put people at the centre of their care, supporting them to make choices about treatment and responding in partnership to changes in their health needs. For example, the trust operated specialist nursing services for bladder and bowels, cardiac rehabilitation, Parkinson’s disease, tissue viability and diabetes.

In addition, patients had access to:

• The QUEST team described as quest matrons, was a multi-disciplinary team that responded to the needs of patients within Calderdale Care Homes. The service provided advice and support to staff in care homes on the prevention and proactive management of the needs of older people. This aimed to help reduce falls, hospital admissions, and GP appointments, it covered approximately 30 nursing and residential care homes. The service operated a triage system and responded to any referral within 4 hours if urgent and within 2 days if routine.
• Hospital at home, provided an alternative option for those who were frail, elderly, or with acute respiratory infections who became unwell and would normally be spending time in hospital. This aimed to help prevent admission into hospital, supported early discharge out of hospital, and increased the overall bed-base available for acute care.
• The community specialist respiratory service (CSRS) provided clinical support to people with existing respiratory conditions, empowering them to manage their health within the community. The service was delivered through crisis coordination and a single point of access, providing initial triage, advice, and referrals, with face‑to‑face crisis intervention available within 4 hours. Patients were provided with an individualised comprehensive management plan and a personalised written self-management plan with rescue medication.
• A self-administration of medicines service, to educate and support patients to manage their medicines and remain at home longer and remain independent.

Where community services had been relocated to different premises, the leaders provided information to demonstrate both staff and patients (Healthwatch) had been involved in the process. The themes identified and responded to were transport, accessibility of the site, parking, staff support and signage,

Leaders ensured staff understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had tailored its practices to meet the diverse needs of its community, so that staff could provide continuity of care and help prevent hospital admissions. For example, specialist nursing services for bladder and bowels, cardiac rehabilitation, respiratory, Parkinson’s disease, tissue viability and diabetes, Quest multidisciplinary team to improve quality of care homes and hospital at home.

Staff told us deferred visits rarely happened. The trust provided the number of deferred visits for the district nursing services, over a 3 month period, between December 2025 and end of February 2026, 254 visits were deferred.(Deferred visits are a planned patient visit that is postponed from the original scheduled date or time because it is assessed as safe and clinically appropriate to carry out the intervention at a later date.) Staff ensured any visits at risk of being deferred had been identified and arrangements made to make sure the patient would be seen on their due day. We observed that staff used appropriate tools to manage their day and plan their visits.

At the previous inspection in 2016 we found interpreting and translation services were not always used appropriately. At this inspection, we found improvements had been made. Staff offered interpretation services and document translation services to patients. The services provided access to both pre-booked and on demand translation services, either face to face, by video and by telephone. A range of languages were available. All leaflets were accessible via the website, details on how to request in alternative language was included on all leaflets. The division fed back any operational issues and opportunities for improvement to the trust’s Interpreting and Translation Quality group.

In addition, in August 2025, the heart failure virtual ward team developed a patient information booklet and patient satisfaction questionnaire. The team worked with a senior nurse and expert by experience volunteer patients and carers to review the information. The team accepted all the feedback from the volunteers to improve the language and flow within the document and make it more accessible to people.

Patients had fed back that the map and instructions to access one of the sites required improving. In response the map was improved to include where parking was available.

The community health services for adults treated concerns and complaints seriously, investigated them and shared lessons learnt with the whole team and wider service. Patients, relatives and carers were referred to the patient advice and liaison service if they wanted to make a complaint and we saw leaflets were available. Between 1 March 2025 and 28 February 2026, the community division received 22 complaints out of these only 6 related to the community nursing services. The main themes were patient care, communication and access to treatment and medicines.

Complaints were reviewed and investigated by the matrons and team leaders, who were independent of the complaint. The head nurse had oversight of complaints. Learning from complaints was discussed at the monthly patient quality and safety board meetings.

The adult community nursing teams did not operate waiting lists. All referrals were triaged on the day they were received by the specialist telephone administration team, with clinical oversight from a clinical lead. Each referral was assessed based on the patient’s presenting need, level of urgency, and clinical risk. Appointments were then allocated in line with the triage outcome, ensuring that patients with the greatest clinical priority were seen first and that care was delivered safely, and in a timely manner. The telephone service operated 24 hours a day, 7 days a week. The urgent calls for a district nurse were responded to within 2 hours, and routine calls were dealt with within 48 hours.

The clinics were mostly held on specific days from Monday to Friday between 8am and 6pm. Specialist services offered face to face clinic and telephone appointments and home visits. Leaders monitored and benchmarked their uptake of appointments and staff followed up patients who did not attend appointments.

The Quest multidisciplinary team were available from 9am to 6pm 7 days a week and provided support to 30 residential and nursing homes.

The high intensity user group (HIUG) provided a robust way of reducing frequent user activity to 999, NHS 111, AE, G.P contacts, hospital admissions and allied community services. The aim was to manage and coordinate the needs of a complex, multifactorial patient group. A multidisciplinary forum reviewed high‑intensity service users, referred by partners, with patient consent, to develop personalised care plans that supported appropriate and effective use of healthcare services.

A self-administration of medicines service, to educate and support patients to manage their medicines and remain at home longer and remain independent, was in place.

The community health services for adults offered frailty and respiratory hospital at home, which provided an alternative option for those who were frail, elderly, or with acute respiratory infections who became unwell and would normally be spending time in hospital. It aimed to prevent admissions into hospital, support early discharge out of hospital, and increase the overall bed-base available for acute care.

The frailty hospital at home was available 7 days a week from 8am to 6pm. The service was commissioned to provide 22 virtual ward beds. As the service was still in development there were currently 16 virtual ward beds available providing both step up and step-down support at the time of our inspection. The respiratory hospital at home had 20 virtual beds.

The Friends and Family survey (FFT) from the previous 12 months showed 96% positive feedback. 2,118 patient comments were received and 2,068 were positive. The positive comments included patients’ treatment, exercises, plans and support were tailored to their individual needs and the outcomes of improved mobility, confidence and ability to self‑manage. Leaders monitored the local community population and worked and collaborated with organisations to tackle health inequalities in the local population. The trust had systems to continually review appointment availability (face-to-face, telephone, and at home), interpreter services, and safeguarding measures to ensure all patient groups could access care.

The trust listened to people who were most likely to experience inequity and aimed to develop services to address this. A Divisional Experience of Care group had been recently formed to work in partnership with people to strengthen and improve their experience of care. The group oversaw and supported the delivery of the patient experience and involvement strategy. The services which were involved with this were cardiac rehabilitation, long COVID, Quest multidisciplinary team and pulmonary rehabilitation. The group looked at areas where the patient feedback had suggested potential improvements.

Services had been developed to improve the experience and outcomes for people who used the service, for example, hospital at home, self-administration of medicines, the high intensity user group (HIUG), the Quest multidisciplinary team and the specialised clinics.

During Carers Week 2025, senior leaders visited community and outpatient services to speak directly with unpaid carers, patients and staff. This gave them an insight into caring experiences, availability of support, practical barriers such as parking and transport, and to look for opportunities to strengthen carer‑friendly practice. Reflections were collated and used to shape follow‑up actions across clinical areas.

We saw staff were aware of patients recommended summary plan for emergency Care and Treatment, (ReSPECT) and completed the forms. This was a process that promoted discussion and shared decision making between a person and their clinical team. The plan was completed by the caseload holder (specialist community practitioner) for the patient’s emergency care and treatment and allowed the patient and their health professionals to plan together for such a future emergency. The current compliance for staff training at the time of the inspection was 94.16%.

Where district nurses were involved caring for patients at the end of life they had the support of the palliative care nurse specialists.