The Isle of Wight NHS Trust has been rated as good overall following an inspection by the Care Quality Commission (CQC). It was previously rated requires improvement.
The Isle of Wight NHS Trust is the only integrated acute, community, mental health and ambulance health care provider in England. Overall, the trust provides 23 core services for acute, community, mental health and ambulance services.
Between 22 June and 23 July, CQC inspected a range of the trust’s mental health and community services, as well as five of the trust’s acute core services. These services included diagnostic imaging, medical services, surgical services, gynaecology services and children and young people’s services. CQC also looked specifically at management and leadership of the trust to answer the key question - is the trust well led?
Inspectors found that a number of improvements had been made and embedded throughout the trust since their previous visit in 2019. As a result, the trust’s overall rating has been upgraded from requires improvement to good. It is also rated as good for whether its services are safe, effective, caring responsive and well led.
As this is a combined trust, each service type was also rated. Acute services and community services were rated as good overall. As only some of the trust’s mental health services were inspected, the service was not fully re-rated, and it remains requires improvement. However, inspectors did note a number of improvements had been made across the mental health inpatient and community teams and acknowledge the work towards improving the care for people that use services.
CQC has also recommended that The Isle of Wight NHS Trust should be taken out of System Oversight Framework level 4 of the new Recovery Support Programme (previously special measures) from a quality perspective following this inspection. Ted Baker, CQC’s chief inspector of hospitals, found that sufficient progress had been made to justify the recommendation to NHS England and NHS Improvement, although the trust will receive ongoing support to ensure that its performance continues to improve.
Ted Baker, CQC’s chief inspector of hospitals, said:
“At this inspection of the Isle of Wight NHS Trust, we found sustainable improvements have been put in place and embedded. This is a great achievement, the more so as it has taken place against the background of the COVID-19 pandemic.
“Throughout the inspection, the team received feedback that was overwhelmingly positive about staff often going the extra mile to support patients. The care and support received exceeded patient’s expectations, and this has resulted in the trust’s community services receiving an outstanding rating for being caring.
“The trust has worked incredibly hard to put the improvements needed in place and I am happy to recommend to NHS England and NHS Improvement that the Isle of Wight NHS Trust should be taken out of System Oversight Framework level 4 of the new Recovery Support Programme following this inspection.
“I want to congratulate all of the staff and the leadership at the Isle of Wight NHS Trust for their hard work and dedication during this time. We look forward to returning at a later date to see what further improvements have taken place.”
CQC found a number of examples of outstanding practice during this inspection, including:
- Major incident response planning had been explored due to the pandemic in a much wider context with drone supplies, armed forces, police and fire brigade support and alternative ways to move unwell patients to mainland trusts, such as via hovercraft
- Patients on chemotherapy treatment had access to a home service if they became unwell. Paramedics were trained to attend and administer a first dose of intravenous antibiotics at home. This meant patients were treated quickly and safely without needing to attend the emergency department
- People living with dementia had access to a reminiscence room and a potting shed area. The reminiscence room had activities for patients with dementia such as puzzles, games and art activities. The potting shed was situated in an outdoor space and encouraged patients to grow edible plants in a planting trough
- The stroke service improved in the Sentinel Stroke National Audit Programme. The service is rated A (the highest rating)
- Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care and information to meet all their needs. Easy read discharge papers with pictures were available for patients with learning disabilities to provide information in a way that they could understand
- During the lockdown restrictions, where visitors were unable to visit the hospital, the service had tablets and mobile phones available for patients to use so they could keep in touch with loved ones. Inspectors also saw an example of a married couple who were able to be accommodated in the same room as they had never previously spent time apart
- Staff empowered patients to have a voice and realise their potential. Patient’s individual preferences and needs were always reflected in how care was delivered and evidenced well in care planning. For example, one patient’s only goal was to be able to walk his daughter down the aisle on her wedding day. Staff worked tirelessly to ensure this was possible.
However, there were some areas for improvement:
- The trust must ensure there are enough clinical psychologists and other appropriate staff to meet the needs of patient requiring this service and that patients are supported appropriately if they need to wait for long periods
- The trust must ensure the environment at the health-based place of safety on Seagrove ward is fit for purpose and meet the requirements of the Mental Health Act Code of Practice, and ensure that the environment provides dignity and respect to users of the service
- The trust must ensure that, on Osbourne ward, staff update patients’ risk assessments following an incident to reflect changing risks and care needs.
Full details of the inspection are given in the report published on our website.
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