Derbyshire Community Health Services 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 patients equally and without discrimination.
At our last assessment, we rated this key question as good. At this assessment, the rating has remained good.
 

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.

Staff made sure patients were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.
Patients received responsive, person-centred care, with evidence of flexibility, involvement, and reasonable adjustments. While improvements were needed in care planning documentation, leaders recognised this and had taken steps to address it.
Patients and those close to them were regularly involved in planning and making shared decisions about care and treatment. A relative told us, “They spoke to me when she came in about all her likes and dislikes.” Staff engaged patients and families in discussions about their condition, care options, associated risks, and benefits, supporting informed decision-making. Patients told us they understood their care and felt involved in decisions that mattered to them.
Staff made reasonable adjustments to ensure patients received the appropriate care. Oker Ward participated in the NHS 15 Steps Challenge, using patient and family perspectives to review first impressions and improve care experiences.
However, care plans and documentation did not always fully reflect patients’ physical, mental, emotional, and social needs. We identified gaps in documentation relating to catheter care, mobility, skin integrity, and communication needs, where care actions and personal preferences were not consistently recorded. This meant records did not always provide clear or sufficiently detailed guidance for staff.
Leaders acknowledged these findings and confirmed they had already identified these issues and had plans in place to strengthen care planning and documentation. Leaders shared how they reviewed records and implemented actions to improve consistency and quality.

Staff understood the diverse health and care needs of patients and their local communities, so care was joined-up, flexible and supported choice and continuity.
Patients received care and treatment from services that understood and responded to the health and social care needs of the local community. Services were flexible, joined up, and designed to promote continuity and positive patient experiences. For example, on Fenton Ward, staff delivered a person-centred line care service for patients requiring chemotherapy pump disconnection or line flushing. This flexible service allowed patients to return to the ward when they felt unwell or needed additional support, improving continuity, reassurance, and access to services. Staff told us the service had been established for over a year and provided patients with greater choice and enhanced support.
Staff delivered care in a coordinated and responsive way that met patients’ assessed needs. Staff worked closely with community services and external partners to support safe transitions of care. This included engagement with the recently developed Care Transfer Hub (CTH) in Derbyshire, which aimed to improve discharge planning and coordination, supporting timely and well-managed transfers from hospital.
Staff considered patients’ individual needs and preferences when delivering and coordinating care, including the needs of patients with protected characteristics under the Equality Act 2010 and those at risk of poorer experiences of care. This approach supported continuity, reduced fragmentation, and helped ensure patients received the right care, at the right time, in the right place.

Staff provided accessible, tailored, and timely information that supported patients’ rights, choices, and involvement in their care. This included up-to-date information in formats that were tailored to individual needs.
Staff identified, recorded, and shared patients’ individual communication needs in line with the accessible information standard. The service had access to interpreter services, including British Sign Language, and could provide information in different formats, such as large print and braille, through the trust’s communication team when required.
Staff supported patients with additional needs by ensuring they had access to hearing aids, glasses, and other aids to support communication. Staff also used available cultural and communication guidance to tailor how information was shared to support patients and families appropriately.
Patients and families received timely and clear information to support their care and treatment. For example, staff displayed predicted discharge dates in patient areas, so patients and families had an indication of a potential discharge date, while explaining that this remained flexible and subject to change. Staff told us patients were informed about how to access their care records and how their personal information could be shared, in line with data protection requirements (GDPR).
 

Staff demonstrated a positive approach to listening to patients, responding to concerns, and using feedback to improve care and experiences.
Staff made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment, and support. They involved patients in decisions about their care and told them what had changed as a result.
Staff listened to patients and involved them in shaping care and service improvements. One patient told us, “They ask me if I’m happy and you can see they care.” Staff managed complaints in line with the trusts policy and demonstrated learning from feedback, including complaints. Staff described changes made in response to patient feedback, showing how learning informed practice.
The service captured feedback through multiple routes, including discharge feedback processes and the ‘worry catcher’ sessions, which provided patients with independent support during their hospital stay. Leaders reviewed feedback and used it to identify areas for improvement and to share learning with staff.
When patients raised concerns, staff clarified whether these were formal or informal complaints. Staff signposted formal complaints to the patient experience team, and matrons investigated informal complaints relating to inpatient care. Many concerns were resolved informally and promptly at ward level. To ensure fairness and avoid bias, the service followed clear processes for managing complaints.

Staff prioritised equity in access, allocated resources appropriately, and worked collaboratively to reduce inequalities and ensure patients received timely and fair access to care and treatment.
Patients could access care, treatment, and support when they needed it and in ways that worked for them. Staff delivered care that was accessible, timely, and in line with legal requirements, quality standards, and equality and human rights legislation. Staff made reasonable adjustments for patients who had disabilities or communication needs, helping remove barriers and protect patients’ rights.
The physical environment and equipment supported accessibility, and staff provided additional support to help patients overcome barriers to accessing care. Patients could access services when needed.
Leaders and staff remained alert to discrimination and inequality that could disadvantage patients. Staff described how they challenged inappropriate behaviour and worked to ensure fair and equitable access for all patients. The service used patient feedback and system-level information to review and improve access where barriers were identified.
Staff worked closely with system partners to support equitable access. The Care Transfer Hub supported fair and consistent referral processes, with referrals shared to enhance oversight and reduce inequity or delay. Where access to mental health support had previously been challenging, staff described improved pathways and closer working with community mental health teams, which improved staff's knowledge and confidence when accessing these services.

Staff and leaders actively listened to information about patients who are most likely to experience inequality in experience or outcomes and tailored their care, support, and treatment in response to this.
Feedback provided by patients using the service, both to the provider and the CQC , was positive. Staff treated patients equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience. Staff understood the importance of providing an inclusive approach to care and made reasonable adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure patients could be referred to the hospital fairly and without bias, including those in vulnerable circumstances. Staff used appropriate systems to capture and review feedback from patients using the service, including those who did not speak English as their first language.
 

Staff placed a strong emphasis on high-quality end-of-life (EOL) care. Records showed that patients were supported to consider and record their wishes for their future care, including decisions about cardiopulmonary resuscitation (CPR). Staff documented all decisions in personalised care plans and shared them with relevant services to ensure continuity of care.
When patients wished to discuss or record CPR decisions, staff supported them sensitively and ensured patients understood that they could change their decisions at any time. When treatment was changed or withdrawn, staff communicated openly and compassionately with patients and the patients important to them, supporting a comfortable and dignified death.
Staff took pride in the quality of EOL care provision. All wards used Derbyshire Alliance for End-of-Life Toolkit to support and guide them when providing good quality end of life care for patients. Saff described going “above and beyond” to meet patients’ wishes wherever possible. Visiting was open and flexible for patients receiving end-of-life care.
Patients receiving EOL care were cared for in side rooms where possible. Families were supported with recliner chairs, meal vouchers, and offers of food and refreshments. Staff focused on getting to know each patient as an individual, capturing what mattered to them and supporting their preferences.
Staff supported patients who wished to die at home with fast-tracked referrals to continuing healthcare and close collaboration with community services. Physiotherapists and occupational therapists played a key role in discharge planning, including discharge-to-assess pathways, assessment in patients’ own environments, and referral to community therapy services. Social workers referred to local authority services where required to ensure appropriate ongoing support.
Staff demonstrated a strong commitment to delivering compassionate, personalised end-of-life care and supporting patients and their families throughout this important stage of care.