Outstanding for Caring - but CQC inspectors find Torbay and South Devon NHS Foundation Trust Requires Improvement

England’s Chief Inspector of Hospitals has rated the services provided by Torbay and South Devon NHS Foundation Trust as Requires Improvement overall following an inspection by the Care Quality Commission.

Torbay and South Devon NHS Foundation Trust is one of a few integrated organisations within the NHS, providing acute health care services from Torbay Hospital, as well as community health services and adult social care services. Overall, the trust was rated Outstanding for caring, reflecting the compassion, support and patient involvement the trust provided in delivering care.

Torbay Hospital was rated as Requires Improvement, with urgent and emergency care services rated inadequate. Community services were rated as Requires Improvement. Mental health services and adult social services were both rated Good, while patient transport services were Outstanding. Within Community services, community health dental care, special care dental services and Community Health services were rated Outstanding.

Reports and full ratings have been published.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“It is seven months since Torbay and South Devon NHS Foundation Trust was formed into an integrated care organisation from two separate trusts.

“I appreciate that it is sometimes hard to manage change in large organisations yet, despite challenges we have found that there is a strong vision for the future of Torbay and South Devon NHS Foundation Trust. The changes have been well managed and the majority of staff feel upbeat about the new organisation and ethos.

“This positive culture and engagement with trust staff has added benefit of teams often going above and beyond to provide outstanding care and support and that is to be applauded.

“However, there are some areas where improvements are required. On our inspection we found there was an apparent lack of urgency to assess or treat some patients promptly by at Torbay Hospital. Poor patient flow especially in the urgent and emergency department was putting patients at risk of avoidable harm.

“I am aware that the trust have started to put measures in place to address our concerns. We will continue to monitor performance and return in due course to check on their progress.”

Inspectors found that staff in the emergency department were positive and professional under pressure. But there were not always enough senior doctors or nurses on duty. In the emergency department, patients did not always receive an initial assessment within 15 minutes. The numbers of nurses on medical wards regularly fell below the level that the trust felt that they needed. In outpatients, there were not enough doctors to allow the trust to address its significant backlog of follow up appointments.

In most services, patient’s needs were assessed and care and treatment delivered in line with best practice. But facilities did not always support effective services. The emergency department facilities were not suitable or well maintained, compromising patients’ safety and experience. A lack of available beds in the hospital resulted in poor patient flow through the emergency department. Delays at times placed patients at risk of harm.

The Child and Adolescent Mental Health Services had difficulty recruiting staff leading to long waits for some patients, particularly children aged five to 18 waiting to receive an autistic spectrum diagnosis.

The trust is the highest achieving in the south west peninsula for cancer treatment targets and had the highest survival rates in the south west.

The critical care unit’s rehabilitation programme was exceptional in responding well to individual patient needs. There was a focus on patients while they were in the unit, and follow-up services in the hospital and in their own homes for patients who had been discharged.

A team of inspectors including specialists and experts by experience spent five days inspecting the trust during February 2016.

The Care Quality Commission will present its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

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