Bromley Healthcare Central court

This was an announced, focused inspection of community health services for children, young people and families and covered some aspects of the safe, effective, responsive and well-led key questions. We undertook the inspection following the death of a baby, who was receiving health visiting services.

We found the following areas of good practice:

• Staff understood how to protect children, young people and their families from abuse and the service worked well with other agencies to do so.
• Staff completed and updated risk assessments for each child and young person and removed or minimised risks. Staff identified and quickly acted upon children and young people at risk of deterioration.
• The service managed safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service.
• The service provided care and treatment based on national guidance and evidence-based practice.
• Managers appraised staff’s work performance and provided opportunities for staff to undertake a range of specialist training courses to enhance their role.
• Leaders had the skills and abilities to run the service effectively. They understood and managed the priorities and issues the service faced.

However, the following areas that the service needed to improve:

• Although the service had governance processes that were well developed and embedded into services, we found some areas for improvement. The service had not submitted all required notifications to the Care Quality Commission without delay. The provider recognised the need to ensure notifications were completed promptly and following the inspection introduced some improved processes that would need to be embedded.
• The service safeguarding children’s supervision policy was not clear, especially for staff who were new to the role and not familiar with the organisation. Staff did not always complete comprehensive safeguarding supervision notes such as mandatory action plan dates. This meant there was a risk that actions to address risks may have been missed or not completed in a timely manner.
• All staff had access to an electronic records system that they could all update, but a few records did not have up to date child protection information and staff did not always complete patient records in a timely manner.
• Some staff told us that they would benefit from additional training for non-mobile babies to ensure they made informed decisions in different scenarios.