South Tyneside NHS Foundation Trust RE9 Community health services for adults Quality Report Tel: 0191 404 1000 Date of inspection visit: 5-8 May 2015 Website: www.stft.nhs.uk Date of publication: 01/12/2015 1 Community health services for adults Quality Report 01/12/2015 Summary of findings Locations inspected Location ID Name of CQC registered Name of service (e.g. ward/ Postcode location unit/team) of service (ward/ unit/ team) RE9GF Palmer Community Hospital RE9GA South Tyneside District Hospital RE9X2 Blaydon Primary Care Centre RE9GA South Tyneside District Hospital Carr Hill Clinic RE9GA South Tyneside District Hospital Bensham Hospital RE9Y3 Monkwearmouth Health Centre RE9GA South Tyneside District Hospital Pallion Health Centre RE9GA South Tyneside District Hospital Flagg Court Health Centre RE9GA South Tyneside District Hospital Clarendon RE906 Elmville Short Break This report describes our judgement of the quality of care provided within this core service by South Tyneside NHS Foundation Trust. Where relevant we provide detail of each location or area of service visited. Our judgement is based on a combination of what we found when we inspected, information from our ‘Intelligent Monitoring’ system, and information given to us from people who use services, the public and other organisations. Where applicable, we have reported on each core service provided by South Tyneside NHS Foundation Trust and these are brought together to inform our overall judgement of South Tyneside NHS Foundation Trust 2 Community health services for adults Quality Report 01/12/2015 Summary of findings Ratings Overall rating for the service Good ––– Are services safe? Good ––– Are services effective? Good ––– Are services caring? Outstanding – Are services responsive? Good ––– Are services well-led? Good ––– 3 Community health services for adults Quality Report 01/12/2015 Summary of findings Contents Summary of this inspection Page Overall summary 5 Background to the service 6 Our inspection team 6 Why we carried out this inspection 7 How we carried out this inspection 7 What people who use the provider say 7 Good practice 7 Areas for improvement 8 Detailed findings from this inspection The five questions we ask about core services and what we found 9 4 Community health services for adults Quality Report 01/12/2015 Summary of findings Overall summary Overall rating for this core service Good l Patients and their relatives were truly respected and valued as individuals and were empowered as partners in Overall community health services for adults were good, their care. Feedback from patients and their families was with caring rated as outstanding. Incidents were reported consistently positive about the way staff treated them. across teams and learning from incidents was identified. Patients thought staff went the extra mile in providing The safeguarding policy was understood by staff and care, treatment, and support.There was a strong person- used as part of their practice. Equipment was used safely. centred culture. Staff were considerate and empathetic The service had infection prevention and control policies towards patients and their relatives. Staff respected in place. Staffing levels were sufficient in most areas to patient confidentiality in written records and other meet current demand. The service had a lone working communications. The approach staff used in the home policy in place and implemented procedures to reduce setting demonstrated compassion and consideration for the risks to staff working alone. The service had plans in the patient. place to respond to major incidents. Patients could access community health services The service undertook a range of audits to improve promptly. Discharge liaison arrangements between the performance and ensure patient safety. Clinical acute hospital and community settings were in place. governance meetings were held regularly. The service Arrangements were in place for the training of clinical had introduced the Friends and Family Test (FFT) patient staff in caring for patients living with dementia. Staff were satisfaction survey in January 2015. The service was in aware of complaints patients had made, and what was the process of introducing integrated care an innovative done to resolve complaints. Following the investigation multi-disciplinary practice model. of complaints actions were identified. This was discussed Staff understood their individual roles and with patients and actions were monitored to completion. responsibilities. Recognised assessment tools were used The service had governance and risk processes in place. for the assessment, planning, and review of patient care The service actively maintained a risk register and and treatment. There was good multi-disciplinary responded to identified risks; long-term staff sickness was working and effective handover and multi-disciplinary not identified on the register. The service planned for team meetings. Staff consistently told us they had good seasonal fluctuations in demand. Managers and staff told links, and access to, a wide range of other services. Staff us they felt integrated care provided a clear vision for felt the executive team were approachable; but the community services. The service had a strategy of community teams were attached to different divisions. improvement and changes to service delivery. Managers and team leaders demonstrated a clear understanding of their role and position in the trust. Local team leadership was effective. 5 Community health services for adults Quality Report 01/12/2015 Summary of findings Background to the service Background to the service South Tyneside who provide care for adults with more than one complex, long term condition, such as: Community services for adults are part of the South diabetes, respiratory disease, or heart disease. Tyneside NHS Foundation Trust. The trust provides a Community matrons visit people in their own homes and variety of community services in South Tyneside, develop personalised care plans. Community matrons’ Gateshead, and Sunderland. co-ordinate care with other health and social care Community services for adults include district nursing, professionals. By doing this they can prevent unnecessary cardiology, eye and diabetic screening clinics, podiatry admission or attendance at hospital, they work with the and a range of other services such as planned care, acute hospital to support discharge home. intermediate care, learning disabilities, and urgent care. During the inspection we visited the following community District nursing services in Gateshead, South Tyneside health services for adults: and Sunderland, provide care predominantly to Out of hours service South Tyneside ACT, Palmer housebound patients, but also in clinics in GP settings. Community Hospital Gateshead UCT, Bensham Hospital The district nursing teams are led by a qualified district nurse (a registered nurse with additional qualifications). District nursing service Blaydon Primary Care Centre Teams include registered nurses (RGN) and health care Palmer Community Hospital Monkwearmouth Health assistants (HCA). The district nurse teams operate a single Centre Pallion Health Centre point of contact (SPOC) for all referrals that are made into Palmer Community Hospital the service. Community matrons Carr Hill Clinic Community services for adults operate a 24/7 rapid Leg ulcer clinic response and out of hours service in South Tyneside and Podiatry clinic Blaydon Primary Care Centre Gateshead. These are nurse led teams, providing support to patients at home to avoid unnecessary hospital Urgent care team Leechmere Centre admissions. Eye/diabetic screening clinic Flagg Court Health Centre Community matrons also operate within the community Cardiology Clarendon services for adults’ structure. Community matrons are a team of nurses working in Sunderland, Gateshead and Learning disability service Elmville short-break service Our inspection team Our inspection team was led by: The team included CQC inspectors and a variety of specialists: Health Visitors, District Nurses, Our inspection team was led by: Physiotherapists, Occupational Therapists, Community Chair: Trish Rowson, Director of Nursing – Quality and Matrons, Dentist and Expert by Experience (people who Safety, University Hospitals of North Midlands NHS Trust. had used a serice or the carer of someone using a service). Team Leader: Amanda Stanford, Care Quality Commission 6 Community health services for adults Quality Report 01/12/2015 Summary of findings Why we carried out this inspection We inspected this core service as part of our comprehensive acute and community health services inspection programme. How we carried out this inspection To get to the heart of people who use services’ experience During this inspection we met with in excess of 110 of care, we always ask the following five questions of managers and staff representing a range of roles and every service and provider: seniority. We included qualified nursing staff, specialist nurses, allied health professionals (physiotherapists, • Is it safe? cardiologists and podiatrists), health care support • Is it effective? workers, team leaders and managers. Interviews were • Is it caring? conducted on a one to one basis, in small groups of two • Is it responsive to people’s needs? or three staff within a service, or in group discussions • Is it well-led? arranged as focus groups. Before visiting, we reviewed a range of information we Inspectors spoke with more than 20 patients in a number