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Cambridgeshire and Peterborough NHS Foundation Trust Cambridgeshire and Peterborough NHS Foundation Trust Evidence appendix Elizabeth House, Cambridge Road Date of inspection visit: Fulbourn 20 May 2019 to 13 June 2019 Cambridge Cambridgeshire Date of publication: CB21 5EF 5 September 2019 Tel: 01223726789 www.cpft.nhs.uk This evidence appendix provides the supporting evidence that enabled us to come to our judgements of the quality of service provided by this trust. It is based on a combination of information provided to us by the trust, nationally available data, what we found when we inspected, and information given to us from patients, the public and other organisations. For a summary of our inspection findings, see the inspection report for this trust. Facts and data about this trust The trust had 10 locations registered with the CQC (on 7 May 2019). Registered location Code Local authority Brookfields Hospital RT1W1 Cambridgeshire Cavell Centre RT199 Peterborough City Care Centre RT1DN Peterborough Fulbourn Hospital RT113 Cambridgeshire Ida Darwin Hospital RT115 Cambridgeshire Addenbrookes Hospital RT190 Cambridgeshire North Cambridgeshire Hospital RT182 Cambridgeshire Princess of Wales Hospital RT1FD Cambridgeshire Doddington Hospital RT1GD Cambridgeshire Ida Darwin Learning Disability & Specialist RT1Y1 Cambridgeshire Services Page 1 The trust had 315 inpatient beds across 24 wards, 36 of which were children’s mental health beds. The trust has not supplied any information regarding the number of outpatient clinics. Total number of inpatient beds 315 Total number of inpatient wards 24 Total number of day case beds Not Supplied Total number of children's beds (MH setting) 36 Total number of children's beds (CHS setting) Not Supplied Total number of acute outpatient clinics per week Not Supplied Total number of community mental health clinics per week Not Supplied Total number of community physical health clinics per week Not Supplied The methodology of CQC provider information requests has changed, so some data from different time periods is not always comparable. We only compare data where information has been recorded consistently. 20190830 RT1 Evidence appendix Page 2 Is this organisation well-led? Leadership The trust board had the appropriate range of skills, knowledge and experience to perform its role. The board was well established. The chief executive had been in post since August 2017 and the chair since July 2014. The board consisted of a chair, the chief executive, director of nursing and quality, director of finance, medical director, director of service transformation, director of people and business development, chief operations officer and director of corporate affairs. There were six non-executive directors and two advisory non-executive directors who had a wide range of skills and suitable experience. This ranged from private business leadership, financial, legal, medical research, HR, technology and third sector organisations. We found that that board was multi-skilled and had a wide range of experience allowing many views and experiences to inform how the trust was led. We attended a trust board meeting during the inspection and saw that the board was focussed on ensuring the delivery of high quality and compassionate care. The trust leadership team had a comprehensive knowledge of current priorities and challenges across all sectors and acted to address them. The trust board and senior leadership team set the tone for the values of the trust on an ongoing basis. The non-executive directors provided appropriate and effective challenge, holding the executive team to account to improve the performance of the trust and ensure that quality and safety were at the centre of all decision making. The trust had an experienced senior leadership team with the skills, abilities, and commitment to provide high-quality services. Each of the trust’s three directorates had a head of nursing, clinical director and associate director of operations. Leadership was developing well in older peoples and adult community services and the children’s and young people’s directorate. This was beginning to pay dividends for example the plans for the children’s hospital were very positive. The leadership team had worked hard to model behaviours and practices that underpinned the values of the trust. The trust had a lead for child and adolescent mental health, learning disability and autism within the relevant clinical directorates. Executive directors and directorate leads were known to staff and visited most services. They provided leadership and the board encouraged feedback from all levels of the organisation. The chief executive also held regular monthly drop-in sessions for staff and had an open direct email system. Front line staff confirmed they found these visits supportive and most knew who the trust’s directors were. Local leadership across the trust was also visible and effective. Staff felt supported by their leaders. Staff confirmed that they found board and senior trust leaders approachable and easy to talk to. Front line staff were particularly positive about the chief executive’s approach. Succession planning was in place throughout the trust, aligned to the trust strategic objectives and leadership capacity and capability was reviewed on an ongoing basis. The trust supported staff to develop their leadership skills. The trust provided a range of leadership development programmes both internally and externally. Leadership training was available for staff at all levels, irrespective of their job role. The trust provided staff with opportunities for career progression. Talent planning had been encompassed in the appraisal system and an ‘effectively managing our talent action plan’ was in place to develop talent to take up critical and hard to recruit posts. The trust had undertaken a review of how they developed and supported leaders. The leadership, talent and organisational development strategy had been developed alongside a coaching strategy aimed at building a workforce that was highly skilled, competent and compassionate, but also empowered and enabled. The trust had worked with the National Leadership Academy to develop a national talent management toolkit. The trust had offered the NHS Mary Seacole Programme 20190830 RT1 Evidence appendix Page 3 locally and invested in an accredited internal leadership development programme. On appointment all managers joined the first 100 days new managers induction programme. NHS trusts are required to ensure that all directors are fit and proper persons. The trust had ensured that relevant policies and procedures included the requirement to check all future senior staff had the met this standard. During the inspection the trust provided us with details of all the checks they had undertaken to meet this regulation. We reviewed the personnel files of senior staff and found that checks were carried out, disclosure and barring checks were completed on appointment and within the last three years. There was an annual declaration of interests and records maintained of professional qualifications and registrations with expiry dates present. Appraisals were completed, with actions identified. The four largest ethnic minorities within the trust’s catchment population are: White (90.8%), Asian/Asian British (4.8%), Black/African/ Caribbean/ Black British (2%) and Mixed/ Multiple Ethnic Groups (1.9%). The trust board did not reflect the ethnic make-up of the local population. The executive board had no (0%) black and minority ethnic (BME) members and six (75%) women. The non-executive board had no (0%) BME members and three (38%) women. We found that there was also underrepresentation at senior manager level for BME groups. We felt that the trust needed to consider further how to address this. Vision and strategy The board and senior leadership team had set a clear vision and values that were at the heart of all the work within the organisation. The trust’s vision and values were embedded at board level and informed how the senior leadership team operated. The board culture was open and honest. The values were embedded within trust processes and the leaders worked hard to make sure staff at all levels understood them in relation to their daily roles. The trust’s vision and values are: CPFT strives to improve the health and wellbeing of the people we care for, our staff and members, to support and empower them to lead a fulfilling life. PRIDE illustrates the trust’s values as detailed below: Professionalism - We will maintain the highest standards and develop ourselves and others...by demonstrating compassion and showing care, honesty and flexibility Respect - We will create positive relationships...by being kind, open and collaborative Innovation - We are forward thinking, research focused and effective...by using evidence to shape the way we work Dignity - We will treat you as an individual... by taking the time to hear, listen and understand Empowerment - We will support you...by enabling you to make effective, informed decisions and to build your resilience and independence Staff had been involved in the development of the trust vision and overall knew of plans to develop their service. Staff were clear about their roles and accountabilities. Managers discussed the values with staff in supervision and appraisals and recruitment processes were based on the values. Staff knew the trust values and demonstrated these in the care that they delivered to patients. Staff spoke with passion and commitment and were able to explain how they worked to deliver high quality care within the budgets and resources available to them. The trust strategy was directly linked to the vision and values of the trust. The trust involved clinicians, patients and groups from the local community in the development of the strategy and from this had a clear plan to provide high-quality care with financial stability. Patients and frontline 20190830 RT1 Evidence appendix Page 4 staff were encouraged to make suggestions for improvements at service level. The trust had responded to feedback and changed the way that it worked as a result. The trust strategy for 2018 to 2021 included four key strategic priorities.
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