England’s Chief Inspector of Hospitals has rated core services provided by the Central London Community Healthcare NHS Trust as Good overall, and Requires Improvement for Safety, following a comprehensive inspection carried out by the Care Quality Commission (CQC) in April 2015.
A team of CQC inspectors and specialists inspected a range of services including walk-in and urgent care centres, community inpatient, end of life, and children and young people’s services, across several locations including Barnet, Hammersmith and Fulham, and Westminster.
Full reports, including ratings for all of the provider’s core services, are available here.
Following the inspection, CQC issued two requirement notices requiring Central London Community Healthcare NHS Trust to take action to improve governance across end of life care and staffing levels within children and young people’s services.
CQC found that the trust board prioritised the development of a vision and strategy, clear accountabilities and effective processes to measure performance and address concerns. Local team leadership was effective and staff said their direct line managers were supportive.
Inspectors observed patients and relatives being treated with dignity, respect and compassion, and found that patients could access community health services promptly.
Managers worked with commissioners of services, local authorities, other providers, GPs and patients to co-ordinate and develop services responsive to the needs of patients.
The trust had identified and reported incidences of pressure ulcers as an area to improve and in response, the trust introduced pressure ulcer prevention and training, structured examinations and distributed resource packs to residential home staff.
Inspectors also identified areas requiring improvement including the safety and governance of end of life care services, and the safety of children and young people’s services. Significant staff vacancies and recruitment issues meant that agency staff were often used to cover vacancies. Agency staff providing end of life care services generally did not have specialist palliative care experience.
Patients within the end of life care inpatient unit did not always have risk and pain assessments completed in line with trust policy due to the recent development of an electronic record system that was yet to be fully embedded.
Edward Baker, CQC’s Deputy Chief Inspector of Hospitals, said:
"We are pleased to report that our recent inspection has found that Central London Community Healthcare NHS Trust is providing a good service overall to local patients.
“Inspectors witnessed how patients and their families and loved ones were treated with dignity, respect and compassion.
“Access to community health services was observed as prompt and responsive to patient needs, and the trust showed commitment to improving health outcomes for local people.
“Although we have found several examples of good care across the trust core services, areas for improvement were also identified.
‘We have concerns about patients within the end of life care inpatient unit not always having risk and pain assessments completed in line with trust policy. Inspectors found that recruitment issues resulted in the regular use of agency staff, who generally may not have the specialist palliative care experience that end of life care patients require.
“Whilst I am satisfied that the trust is providing effective, responsive, caring and well-led services, I look forward to improvements being implemented upon our next inspection to ensure that the safety of service provision meets all the required standards.”
CQC has told Central London Community Healthcare NHS Trust that it must take action to address a number of areas that require improvement, including:
- A review of recruitment and retention of staff in health visiting, school nursing and occupational therapy.
- A review of the patient record system used within the Pembridge Palliative Care Unit to ensure that all staff are able to participate in recording patient assessments and care plans in a way that meets safety requirements.
- Risk assessments to be completed on all patients in line with trust policy.
- An implementation plan for the development of end of life care guidance to ensure consistency of care.
- The use of pain assessments to continuously reviewed to ensure effective use and management of patients’ pain.
- Guidance regarding nutrition and hydration for patients at the end of life to be made available to staff caring for them.
The trust must submit a report to CQC detailing the action that will be taken to ensure required standards are met and to address the areas identified as requiring improvement.
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For further information please contact Yetunde Akintewe, CQC Regional Engagement Manager, on 07471 020 659.
For media enquiries about the Care Quality Commission, please 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 (please note: the duty press officer is unable to advise members of the public on health or social care matters). For general enquiries, please call 03000 61 61 61.
Although we have found several examples of good care across the trust core services, areas for improvement were also identified
Edward Baker, Deputy Chief Inspector of Hospitals