England’s Chief Inspector of Hospitals has told Cornwall Partnership NHS Foundation Trust that it must make improvements in the quality of its services.
Cornwall Partnership NHS Foundation Trust took over the provision of community health services previously provided by Peninsula Community Health Community Interest Company in April 2016 and this was the first inspection of the trust following that change.
A team of inspectors from the Care Quality Commission visited Cornwall Partnership NHS Foundation trust as part of its comprehensive inspection programme. As a result of this inspection, CQC has rated the trust as Requires Improvement overall. CQC also rates all services on five key questions. It has rated the trust as Outstanding for Caring; Good for Responsive, and requires improvement for Safe, Effective and Well led. You can download the report in full from our website.
CQC’s Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said:
“We rated Cornwall Partnerships NHS Foundation Trust as Good when we last inspected it. Since that time, the trust has acquired community services previously provided by Peninsula Community Health Community Interest Company. We recognise that it can be difficult to take on new services in this way."
“We have made it clear to the trust where it must take action to improve these services. Since the inspection the trust has been responding to these safety concerns and making changes to lessen the risks. We will continue to monitor the services involved, and we will take further action if that is required to protect the interests of patients. We will in any case return in the near future to check progress."
“Our rating of Outstanding for the Caring key question is a tribute to the trust’s frontline staff; who we found them to be caring and conscientious."
There were a number of safeguarding raised in April 2016 but the trust had implemented an ongoing action plan to address the concerns raised was subject to monitoring from the local authority.
CQC found that not all of the premises were suitable for patient assessment or treatment. Inspectors found that Falmouth, Newquay, Bodmin and Liskeard hospitals stored hazardous substances in unlocked areas, including bleach tablets, cleaning solutions and nail varnish remover. Bolitho House, Truro Health Park and St Austell required improvements. Within some community health services, lone working systems and processes did not ensure the safety of staff which left staff working on call vulnerable and posed a risk to their safety.
Some of the community-based services did not have a sufficient number of staff. There were approximately 114 patients who were not receiving treatment at the time of the inspection and the trust did not have a clear process in place to monitor these patients. In the certain areas of the trust reception staff did not always work out of core hours or at weekends and there was no observation of patients at these times; there was a risk that patients with serious or life-threatening conditions may not be identified promptly. In the specialist community mental health services for children and young people there was a high threshold to access specialist support for young people with mental health problems.
The trusts’ medicines management processes were not robust in all trust clinical settings; not all clinic rooms contained the right equipment and in some cases where there was medical equipment it was not tested in line with the trust policy. None of the six integrated community mental health teams had a robust process in place for the management of medicines.
Cover provided by pharmacists and pharmacy technicians across the community inpatient service was inconsistent.
But, inspectors did find staff delivering care and treatment to patients in a kind, caring manner that respected their dignity. Where concerns had been expressed by patients and carers this had been addressed appropriately and in line with the expectations of duty of candour. Staff described an awareness of the need to be open and apologise to patients when necessary.
There was a strong commitment to patient safety, the community team for learning disabilities and autism would routinely follow up service users discharged from their service to identify any changes to their epilepsy. This aimed to reduce cases of sudden death in epilepsy.
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