Chief Inspector of Hospitals publishes report on the quality of care provided by Leeds Community Healthcare NHS Trust

England’s Chief Inspector of Hospitals has published his first report on the quality of the services provided by Leeds Community Healthcare NHS Trust following an inspection by the Care Quality Commission.

Overall, the trust has been rated as Requires Improvement. Inspectors found that services were caring, effective and well led, but that the trust required improvement to be safe and responsive particularly in relation to its community inpatient services, and community child and adolescent mental health services.

An inspection team which included CQC inspectors and analysts, doctors, nurses, patient experts by experience, other specialists and senior managers, spent four days visiting the trust’s community services during November 2014. A further unannounced visit to the trust’s child development services also took place.

Inspectors examined the care provided in community services for children and families including health visiting and school nursing, services for adults with long-term conditions, district nursing services, community rehabilitation services, and services for adults requiring inpatient services. During the inspection they assessed the quality and safety of services and spoke to patients and staff.

Full reports including ratings for all of the trust’s core services are available at: www.cqc.org.uk/provider/RY6.

Inspectors found that staff treated patients with compassion, kindness, dignity and respect. Services promoted independence, people were involved in decisions about their care and treatment, and patient feedback was positive.

The trust had a good incident reporting culture where staff understood and fulfilled their responsibilities to report incidents and there was evidence of improvements as a result of learning from incidents that had occurred.

The inspection team found areas of good practice such as the trust’s Member’s Zone which encouraged children and young people to become involved and influence how services were delivered. In addition, the trust’s Stammering Centre provided a self-help group for teenagers who stammer where they were able to meet with other young people on a regular basis to offer support and to practice fluency.

However, inspectors raised concerns with regards to staffing levels across a number of services at the trust. At the South Leeds Independence Centre, inspectors found a high reliance on bank and agency staff was impacting on the continuity of care and on the workload of the permanent staff that had to support the agency staff. There was a shortage of staff across a number of community services and a review of staffing rotas for adult community services indicated that actual staff members per shift were sometimes less than the number required or planned for.

Inspectors were concerned about the safety of the premises at Little Woodhouse Hall which provides inpatient services for children and young people with mental health needs. Staff had not identified all the potential risks from fixtures that could be used by patients to self-harm and it was difficult for staff to observe all parts of all wards due to the layout of the building. The trust had identified the premises were not suitable, but did not have a clear timescale for moving to new premises or have plans in place to improve the present premises whilst they waited for the move.

CQC identified some additional areas where the trust should make improvements (for full details, see the report). These included ensuring that:

• People are protected against the risks of unsafe or inappropriate care and treatment arising from a lack of proper information about them in their records. Staff had not always recorded peoples risk assessments on the computer system.
• Young people, children and families are able to access community child and adolescent mental health services they need within a reasonable time frame.
• Staffing levels in adult community teams are reviewed to ensure they are safe, especially at times of high vacancies.

Ellen Armistead, Deputy Chief Inspector of Hospitals (lead for Community Health Services), said:

“When we inspected the services run by Leeds Community NHS Foundation Trust, we saw a variation in the safety and quality of treatment and care provided.

“There were several examples of good practice in services which were really going the extra mile to improve the support that they provided to people. However, we also saw other services where more needed to be done to make sure that care and treatment consistently met the required standard. This trust also needs to continue to work with stakeholders to improve some of their premises so that they properly meet people’s needs.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. The trust has told us they have listened to our inspectors’ findings and have begun to take action where it is required. We will return in due course to check that the improvements needed have been made.”

Ends

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