The Care Quality Commission has rated Chelsea and Westminster Hospital NHS Foundation Trust Good overall, following an inspection between December 2017 and January 2018.
The trust was rated Good in all five domains CQC rates: for being safe, effective, caring, responsive and well-led.
The trust runs services at Chelsea and Westminster Hospital and West Middlesex Hospital. It provides urgent and emergency care, medical care, surgery, critical care, maternity and gynaecology, children’s and young people services, end of life care and outpatients services at both hospitals.
CQC did not inspect critical care, maternity or HIV and sexual health services because the information reviewed about the services indicated no change in the safety and quality of these services. Maternity and critical care were rated as Good, HIV sexual health services were rated Outstanding at the previous inspection.
Inspectors found that the trust had learned from CQC’s previous inspections at the two sites and had put in place improvements in the domains that had been rated previously as Requires Improvement.
Staff were proud to work for the organisation and engaged with managers and senior leaders. The trust had consulted with staff and patients at both sites in developing its values.
The trust leadership team was stable and, with a clear example from the chief executive, were highly visible at both sites and took part in a regular programme of ward and departmental visits. The trust board and senior leaders had offices at both sites, and trust board meetings rotated between the sites.
Inspectors noted the openness and honesty displayed by the trust at all levels, not seeking to hide areas where development and improvement were still needed but acknowledging them and making clear remedial plans.
There were clear examples of innovation and research across services and in individual cases. CQC found a genuine no blame, learning culture and a continued determination to improve.
Patients and carers gave positive feedback about the care they received. They said they were involved in decisions about their care and that staff considered their emotional well-being, not just their physical condition.
The trust had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community. Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
CQC found outstanding practice for caring in urgent and emergency care and services for children and young people at Chelsea and Westminster Hospital. In both services inspectors witnessed clinical staff interacting with patients and their family members and carers in a caring, polite and friendly manner. Staff were highly motivated to offer care that promoted people’s dignity.
On medical wards at Chelsea and Westminster Hospital the work on Nell Gwynne and David Erskine ward in relation to elderly patients including those living with dementia was outstanding. Staff engaged patients in a wide range of activities and were passionate about the needs of these patients.
Inspectors saw staff on the Burns Unit used evidence based practice to improve outcomes for patients. Staff showed outstanding contribution to new ways of wound healing and acted as leaders within their speciality and now share their practice with other NHS providers.
End of life care had a high profile throughout the hospitals on both sites. There was a focus on improving the experience for patients nearing the end of life and there appeared to be a widespread commitment to achieving this.
On medical wards at West Middlesex Hospital, the Kew ward team had developed an innovative mouth care project following feedback from patients and relatives and a review of patient outcomes. This involved identifying more effective equipment for mouth care and more consistent care pathways. The team aimed to implement a trust-wide policy as a result of this work, which had resulted in a reduction in cases of acquired pneumonia as a result of poor mouth care.
However, there are areas where the trust should take measures to improve care. These include:
In Urgent and emergency services: The service should ensure that consultant cover continues to increase to provide 16 hours per day consultant cover as per Royal College of Emergency Medicine guidelines. The Emergency Department at West Middlesex should provide more information to patients to help them lead healthier lives.
In medical care: Review medical cover at night in order to address continuing staff shortages at night at Chelsea and Westminster Hospital. West Middlesex Hospital should improve oversight of storage areas used for chemicals and cleaning equipment.
In surgery: West Middlesex Hospital should improve its response rate for complaints and adhere to their own policy of responding to complaints within 25 days. Both hospitals should continue its implementation of one electronic patient record.
England’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“Chelsea and Westminster NHS Foundation Trust was rated Good overall - and in all the domains that we rate.
“This is a fine achievement and I congratulate the trust and its staff on the improvements that have been made since our last inspection.”
You can read the report in full, including CQC's ratings grid for the trust, when it is published on our website.
Ends
For further information please contact Ray Cooling, Regional Engagement Manager (London), on 020 7448 9136 or call the press office on 020 7448 9401 during office hours.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.
This is a fine achievement and I congratulate the trust and its staff on the improvements that have been made since our last inspection
Professor Ted Baker, Chief Inspector of Hospitals