The Care Quality Commission (CQC) has rated Derbyshire Healthcare NHS Foundation Trust as Good overall, following an inspection.
CQC inspected the trust between 13 and 15 January 2020, finding significant improvements. The trust was previously rated Requires Improvement, following a 2018 inspection.
In addition to being rated Good overall, inspectors rated the trust Good for four of the five key questions CQC asks: ‘is it effective, caring, responsive and well-led?’. The trust is rated Requires Improvement for the key question ‘is it safe?’.
CQC deputy chief inspector for mental health and community services, Kevin Cleary, said: “Derbyshire Healthcare NHS Foundation Trust has made important improvements, benefiting people using its services.
“Community health services for children and young people – including community pediatrics and physiotherapy – were excellent and rated Outstanding. Services met individual needs while being accessible without long waits. This was a significant improvement, driven by good leadership.
“Mental health crisis services and health-based places of safety – supporting people in their own homes, at the Hartington Unit at Chesterfield Royal Hospital and Radbourne Unit at the Royal Derby Hospital – were more effective compared to 2018. Staff worked collaboratively, eliminating gaps in care.
“Work was well managed in community mental health services for people with a learning disability or autism. Staff gave patients the time they needed, and premises were safe and clean.
“Although we saw improvements in community-based mental health services for adults of working age, more progress was needed. The service was more responsive to people’s needs, but staff in one team did not feel respected, valued, supported or able to raise concerns.
“Acute wards for adults of working age and psychiatric intensive care units had addressed many of our previous concerns. However, staff needed to ensure best practice when supporting secluded patients.
“Overall, the trust is to be congratulated for improvements it has made.
“Following the inspection, we reported our findings to the trust. Its board knows where it has issues to address. We continue to monitor the trust, and this will include future inspections.”
Inspectors witnessed areas of outstanding practice across the trust, including:
- Support for staff to discuss emotional and social aspects of working in healthcare, improving stress reduction.
- Effective equality and diversity engagement.
- Introduction of handheld electronic devices, improving patient observation recording.
Inspectors witnessed areas of outstanding practice in community health services for children and young people and families, including:
- Improved attention deficit hyperactivity disorder (ADHD) diagnosis.
- Boxes of tactile objects explaining the parent-baby journey, including an expanding ball showing the benefit for fetal brain development when parents spoke to and rubbed the baby bump.
- An award-winning approach to supporting people living with cerebral palsy, and effective baby monitoring for early diagnosis of the condition.
- A handbook for children with fine motor problems, introduced to every Derby and south Derbyshire school.
- Collaboration between the children in care team and other public services to reduce criminalisation of young people in care. This reduced offences involving young people in care, calls to the police and instances of missing and absent young people.
CQC has told the trust it must make some improvements, including:
- Reviewing mandatory training courses, ensuring compliance with targets.
- Reviewing blanket restrictions affecting secluded patients on acute admission wards and undertaking individual risk assessments.
- Any illicit drugs must be actioned in line with policy.
- Implementing required governance processes to ensure acute admission wards are safe.
- Approaching and recording risk assessments consistently in health-based places of safety.
- Ensuring all staff in community-based mental health services for adults of working age have adequate leadership and supervision, as well as clinical guidance and support with incidents.
Full reports for the trust will be published on CQC’s website tomorrow (Friday) at the following link: www.cqc.org.uk/provider/RXM
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