Hounslow and Richmond Community Healthcare NHS Trust has been rated Good overall by the Care Quality Commission. Previously it was rated Requires Improvement
It was rated Good for being safe, effective, caring, responsive and well-led, following an inspection in June and July 2018.
The core services CQC inspected were urgent treatment centres, community health services for adults and community end of life care. CQC selected the services for inclusion in this inspection based on those that were Requires Improvement at a previous inspection.
The trust provides services from 15 main sites, including: Hounslow Urgent Care Centre, located at West Middlesex Hospital, where the trust provides urgent treatment for minor injuries and illnesses; Teddington Memorial Hospital, where the trust has 29 inpatient rehabilitation beds and an urgent treatment centre; and Thames House, the headquarters for a range of community services delivered at clinics and health centres across Hounslow and Richmond boroughs.
Inspectors found some areas of outstanding care, including:
- In the Hounslow Urgent Care Centre, the patient champion service worked well to support homeless patients regarding access to services.
- The trust was the first to use a wound care app, an online electronic reference guide for appropriate treatment of wounds.
- The wheelchair hub in Hounslow offered comprehensive wheelchair, seating and sleep systems for people with long-term mobility problems.
- Intravenous therapy nurses developed a new pathway for administering intravenous antibiotics via a small portable antibiotic infusion pump that patients could either wear around their necks or place in their pockets when at home.
- The children’s continuing care team delivered high quality care to children receiving end of life care. Relatives with whom the CQC spoke said the team were a lifeline during periods of distress.
CQC’s overall findings indicated that all areas made improvements. Staff understood their responsibilities to raise concerns, to record safety incidents, and to report them appropriately. Staff had access to necessary equipment and medicines and had a range of policies and procedures based on national standards to support their work.
People’s physical, mental health and social needs were holistically assessed. Staff were kind, caring and treated patients with dignity and respect. Patients spoke of the positive care they received.
Services delivered were accessible and responsive to people with complex needs or in vulnerable circumstances. People with the most urgent needs had their care and treatment prioritised.
Leadership teams were visible and supportive to frontline staff and demonstrated good knowledge and understanding of the services they provided. Managers made a concerted effort to involve staff in changes to services. There was a positive organisational culture, which supported openness and transparency.
However:
- The vacancy rate for registered adult nursing staff was high at 22%, which the trust recognised. Nursing staff in Hounslow said the shortage of staff resulted in a heavy caseload, which sometimes made for a stressful working environment.
- In the urgent treatment centre at Teddington Memorial Hospital, the waiting area was small and patients attending at reception could be overheard by others, impacting on their privacy.
- There were inconsistences in the completion of some aspects of patient notes.
The Chief Inspector of Hospitals, Professor Ted Baker, said: “There has been an all-round improvement at Hounslow and Richmond Community Healthcare NHS Trust, and I’m pleased to see the overall rating has now improved to Good.
“I was particularly pleased to see some areas of outstanding practice including the children’s continuing care team which delivered high quality care to children receiving end of life care. Relatives our inspectors spoke with said the team were their lifeline during periods of distress.”
Please note you can read the report in full when it is published on CQC’s website at www.cqc.org.uk/provider/RY9
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