The Care Quality Commission (CQC) has rated the services provided by County Durham and Darlington NHS Foundation Trust to be Good overall.
A team of CQC inspectors visited the trust in July 2019 to assess three core services that were previously rated Requires Improvement: urgent and emergency care, surgery and end of life care. Inspectors also looked specifically at management and leadership to answer the key question: is the trust well-led?
The trust had previously been rated Requires Improvement following an inspection in September and October 2017. Following the latest inspection effective improved to Good. The trust maintained its previous Good ratings for being caring, responsive and well-led. Safe remained rated as Requires Improvement.
Both University Hospital North Durham and Darlington Memorial Hospital improved to Good overall.
CQC has also published the trust’s Use of Resources (UoR) report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Good for using its resources productively. The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Good.
The full report, including ratings, is available at: www.cqc.org.uk/provider/RXP
Sarah Dronsfield, Head of Hospital Inspection, said:
“Throughout our inspection we found staff to be caring and compassionate. They worked to improve the care and support they provided and included patients in their care decisions. We also saw staff seeking people’s feedback, so services can meet their needs in the future. We reported significant improvements throughout our visit, predominantly in end of life care. The trust has clearly listened and taken on board the previous inspection’s findings and acted upon them for the benefit of people they support.
“Whilst there is still some work to do, particularly around the safety of some services, it is pleasing to see the trust is continuing to improve and develop its services. We will continue to monitor the trust and engage with them regularly to ensure improvements are made and sustained.”
At Darlington Memorial Hospital inspectors found action had been taken to improve services since the previous inspection. There were enough skilled and experienced staff in the urgent and emergency department to provide good continuity of care, staff also collected information so that safety could be improved. The surgery department was also staffed well and was managing incidents well, taking the necessary action to openly and honestly investigate incidents and learn lessons when things went wrong. Leaders of the service supported staff to develop their skills and were spoken about positively. There was a positive culture and an achievable strategy for future progress. But, inspectors did report that challenges on patient flow and access to services remained.
Similar improvements had been implemented at University Hospital North Durham. Staff in services were skilled and experienced, and deployed well throughout. Managers promoted a positive culture which staff acknowledged. Staff were consulted on the development of a future trust strategy, so it would be inclusive of the local population’s needs. Services engaged well with people and proactively sought their feedback to improve services and seek out innovative solutions.
End of life care at both hospitals improved significantly from the previous inspection and was rated Outstanding. There had been significant restructuring of the service, including new consultants, with leadership directing improvements based on national guidance. Staff treated people with compassion and appropriate emotional support, were well trained, worked within best practice and monitored the quality of the care.
The service took people’s personal preferences and needs into account when planning care and staff sought to make reasonable adjustments to better support people accessing the service.
Inspectors also reported the service was working well within the local community to co-ordinate care and support people in their choice of where to receive care, in hospital or at home.
However, staff in the urgent and emergency department of University Hospital North Durham raised concerns about lone working and security at night, and inspectors were additionally concerned about the level of public access to the department which could risk people’s safety. In the hospital’s recovery area there wasn’t a dedicated paediatric trained nurse which is recommended as best practice, and inspectors visiting the day surgery unit found some utility rooms, containing hazardous substances, were unlocked – although this was immediately rectified.
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