Chief Inspector of Hospitals publishes report on the quality of care provided by Central Essex Community Services C.I.C.
17 Apr 2014 03:27 PM
England's Chief Inspector of Hospitals,
Professor Sir Mike Richards, has published his first report on the quality of
care provided by Central Essex Community Services C.I.C. (now known as
Provide)
In
general, the Care Quality Commission (CQC) inspection found that that Central
Essex Community Services C.I.C. provided safe care and that there was effective
leadership in most services. However, the regulator has told the service it
must improve the way it reports and learns from incidents that may have
compromised patient safety.
Since patient care is often provided by a number of
different community services, the inspectors looked at how well these services
work together. For Central Essex Community Services C.I.C. inspectors found
that most of these ‘pathways’ of care met the needs of patients,
families and carers. The exception to this was end of life services, where
there was a lack of direct consultation with patients, families and carers and
where the planning and delivery of services was not always well coordinated
between inpatient and community teams.
This is the first report of its kind on health services
provided in the community and is the result of a new-style inspection by larger
teams that include specialist doctors and nurses as well as people who use
services.
Inspectors looked at a range of services provided by
Central Essex Community Services C.I.C., including diabetes management,
community rehabilitation services, physiotherapy, wound care, respiratory care,
child health assessment, immunisation and end of life care.
The
majority of people inspectors met were positive about their care, especially in
relation to services provided to children and families. Inspectors found some
examples of good, innovative practice, such as the care given to patients by
the children’s speech and language therapists, which had won a national
award.
They found that staff were committed to providing the
best care they could and there was effective multidisciplinary team working,
providing care that was based on people’s individual needs and on
maintaining people’s independence.
The
greatest concern with the service was that the systems to manage risk were not
good enough. Staff were not always aware of how to identify and consider
serious incidents, near miss incidents and risks and what they would do with
the information. For example, inspectors found instances where missed community
nurse visits or long waits for ambulance transport for deteriorating patients
were not reported by staff. In another case, staff were found not to have
implemented actions to prevent the risks to ensure syringe drivers were tamper
proof. There was also inconsistency in classifying and reporting of pressure
ulcer incidents.
Inspectors were concerned to find the staff skill mix,
including the ratio between substantive and agency staff at Braintree Community
Hospital was inadequate with a high number of agency nurses being
employed.
Other areas for improvement include making sure detailed
care plans are in place for children and young people and that they, or their
families, have been involved in the plan; increasing staff awareness of formal
child protection processes and ensuring staff have training to help them
understand the needs of people with dementia; ensuring staff understood adult
safeguarding procedures, including how to escalate concerns.
Professor Sir Mike Richards, Chief Inspector of
Hospitals, said: "This was one of the first inspections where we have
looked at such a wide range of services in the community. On all of our
inspections, inspectors ask whether a service is safe, effective, caring,
responsive to people’s needs, and well-led.
"We found Central Essex Community Services C.I.C.
to be generally safe for patients, although we had some concerns about staff
awareness of safeguarding systems and about end of life
services.
"In general services were effectively meeting the
needs of patients, families and carers, with some issues about waiting times in
some children’s services.
"Feedback from patients, families and carers gave
us confidence that services were caring and we found that staff worked hard to
meet people’s individual needs, although more could be done to involve
patients, families and carers in the development of services.
"Overall, services were well-led, with staff
feeling well supported and showing a commitment to the values of the
organisation. I am pleased to see that this was reinforced by a visible
leadership who help to motivate staff."
Notes to editors
For
media enquiries, call the CQC press office on 020 7448 9401 during office hours
or out of hours on 07917 232 143.
For
general enquiries, call 03000 61 61 61.
Alongside a report on Central Essex Community Services
C.I.C. as a whole, CQC is publishing individual reports on St Peter’s
Community Hospital Ward, Halstead Community Hospital Ward and Braintree
Community Hospital Ward. The reports are published on CQC’s web site
[LINK] The Care Quality Commission has already presented 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.
Central Essex Community Services Community Interest
Company Central Essex Community Services C.I.C. is a provider of integrated
health and social care and supplies a broad range of community services across
Essex, Cambridgeshire, Peterborough, and the London boroughs of Waltham Forest
and Redbridge