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Provider: Birmingham Community Healthcare NHS Foundation Trust Requires improvement

Reports


Inspection carried out on 15 May to 21 June 2018

During a routine inspection

Our rating of the trust went down. We rated it as requires improvement because:

  • We rated effective, caring and responsive as good. We rated safe and well led as requires improvement.
  • We rated well led for the trust overall as requires improvement. The rating for well led is based on our inspection at trust level. Taking in to account what we found in individual services. Ratings for other key questions are from combining ratings for services and using our professional judgement.
  • At core service level we rated effective, caring and responsive as good overall. We rated safe and well led as requires improvement. This meant we rated community inpatient services as good overall and community services for children and young people as inadequate overall. In rating the trust, we took in to account the current ratings of the core services not inspected on this occasion.
  • Community health services for children and young people went down from good to inadequate overall. The question of safety went down from good to inadequate. Effective went down from good to requires improvement. Caring stayed the same as good. Responsive stayed the same as requires improvement, and well led went down from good to inadequate. Mandatory training and safeguarding training were below target. The safeguarding children policy did not support staff effectively. Staffing levels and performance were not aligned to national standards. Staff did not adhere to infection prevention and control standards. Systems to secure investigation, audit and learning were inefficient. Care planning was inconsistent and referral to treatment waits were beyond the 18-week target for therapy and child development services.
  • Community inpatient services remained good overall. The question of safety went down from good to requires improvement. Effective, caring, responsive and well led remained good. Patient risks were assessed and managed appropriately and incidents were managed and lessons learned. Staffing levels were planned and managed well. Staff used evidence based interventions and best practice guidelines, auditing their practice. Teams were made up of staff from a wide range of disciplines to meet the needs of the patient groups they worked with. Staff were supported in ensuring they were reflective in their practice and identified learning and skills areas for improvement. Staff understood the principles relating to mental capacity and restrictions placed on the patient’s liberty. Staff worked compassionately and displayed a caring and patient centred approach. Patients found services accessible and stakeholders were involved to ensure needs were met. Leaders were efficient at managing resources and a supportive environment. Governance arrangements were in place and staff understood their responsibilities. We found areas for improvement relating to staff training and appraisals along with patient access to services.


CQC inspections of services

Service reports published 15 October 2018
Inspection carried out on 15 May to 21 June 2018 During an inspection of Community health services for children, young people and families Download report PDF | 390.01 KB (opens in a new tab)Download report PDF | 1.91 MB (opens in a new tab)
Inspection carried out on 15 May to 21 June 2018 During an inspection of Community health inpatient services Download report PDF | 390.01 KB (opens in a new tab)Download report PDF | 1.91 MB (opens in a new tab)
Inspection carried out on 23-27 June 2014

During a routine inspection

We found that the provider was performing at a level which led to a judgement of Good. Services were safe, staff reported incidents and near misses and learning took place. The majority of services had sufficient staff though there were a number of vacancies across most teams, especially administrative staff, which were impacting on the delivery of services. Staff received suitable training and supervision.

Services were delivered using evidence based practice, and were delivered through multidisciplinary teams utilising care pathways. The majority of premises were fit for purpose and equipment was available for staff to access in the community.

Staff were caring and compassionate, and we saw some excellent examples of care especially in end of life services. The majority of services were responsive to the needs of patients, and there were innovative examples of care delivery. However there were some services, particularly in dental and children and family services where services were not as responsive as they should be.

The trust is well led, with an accessible and visible executive team, especially the chief executive and executive nurse. Governance systems and processes are in place and there is performance and quality management information available. Quality is high on the trusts agenda.