Chief Inspector of Hospitals publishes his findings on Humber NHS Foundation Trust

England’s Chief Inspector of Hospitals has published his first report on the quality of care provided by Humber NHS Foundation Trust.

Following an inspection in May 2014, the Care Quality Commission found that while there were many examples of good practice, there were significant variations in the quality of the trust's services, with staff stretched to meet demand. CQC has told the trust that it must take action to improve. The full report can be found on the CQC website here.

Humber NHS Foundation Trust provides services to nearly 600,000 people in the city of Hull, the East Riding of Yorkshire, and parts of North and North East Lincolnshire and North Yorkshire, as well as some specialist services to people from other parts of the country. The trust is responsible for both mental health services and community health services, community services being provided in East Yorkshire only.

Overall, inspectors found that most people who use services had positive experiences of care. Patients, families and carers felt well supported and involved with their treatment and staff displayed compassion, kindness and respect at most times. The care provided to people in the majority of services was evidence based and focussed on the needs of the patients. There were examples of good collaborative work and innovative practice.

But the CQC inspection team did note some issues in respect child and adolescent mental health services. Children could be on a waiting list for many months - although they and their families reported that services were very good once a worker was allocated to them. Parents were worried about the gaps in the service out-of-hours and during crises.

In the mental health services, community teams had experienced a rise in referrals, which meant that people were on waiting lists for too long before their treatment started. There were also long waiting lists for paediatric speech and language therapy services. Community nurses were not meeting their four hour targets for urgent referrals, or the target for visiting new patients.

Most of the trust's hospitals were well maintained although the mental health seclusion suites at Derwent and Ullswater at the Humber Centre were not in a good state of repair. Inspectors identified ligature points within these suites that posed a risk to patients’ safety.

The inspection team which included CQC inspectors Mental Health Act commissioners, psychiatrists, a specialist registrar, specialist nurses, occupational therapists, psychologists, and hospital managers spent five days at the trust during May and June 2014.

The inspection team found several areas of good practice which included:

The routine use of My Shared Pathway within mental health teams ensured that people felt more involved in their care plans and able to contribute to their content. Support from pharmacists was good across all wards, especially at Avondale, the assessment ward. A practitioner role had been set up to prevent patients who were elderly or had serious illnesses, such as heart problems or diabetes, from being frequently admitted to the emergency department. They identified risk and relapse plans for patients with deterioration of health and identified named cover for the patients

However, the inspection team also found that the trust must improve in a number of areas including:

The trust must ensure that the environment and ligature risk reduction in the seclusion rooms at Derwent, Ullswater and Green trees wards adhere to the Mental Health Code of Practice. The leave arrangements in place for informal patients at St Andrews ward must take into account the least restrictive principle and their status in accordance with the Mental Health Code of Practice. During the inspection, staff engagement was mixed, and depended on which service people worked in. The trust must address the leadership and staff engagement issues within the children’s services.

• The trust must have an effective system in place to identify, and manage the risks among young people on its waiting lists.
• The trust must take action to ensure that all incidents that result in harm for a child or young person are reported internally, and investigated and all recommendations fully implemented.
• The trust must take action to ensure that all staff working within child and adolescent mental health services adhere to safeguarding children’s procedures and that all incidents that result in harm are referred to the appropriate local authority safeguarding team.
• Staff at St Andrew’s Place must receive training in basic food hygiene.

Professor Sir Mike Richards, Chief Inspector of Hospitals said:

“Although Humber NHS Foundation Trust provides a wide range of services, we have found a number of common themes emerging from our inspection.

We met with committed staff who were passionate about providing good services. Most staff were positive and clear about their role and purpose, although under some pressure.

It is clear that the demand for their services is increasing, as it is across the NHS. While we have seen some examples of very good collaborative work and innovative practice – we found that the demand on the service was affecting the delivery of care and treatment, with waiting lists and caseloads growing.

I note that the trust has taken action to address response times in community nursing services through the appointment of temporary workers. They will need to work with the commissioners to agree a longer term solution which provides high quality services for the people who depend on them.”

Ends

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