Health trust must improve

The latest inspection by the Care Quality Commission, the independent regulator of health and social care in England (CQC), of services provided by Cornwall Partnership NHS Foundation Trust (CPFT) has rated it as Requiring Improvement overall.

Amanda Stratford, CEO at Healthwatch Cornwall said: “The findings are consistent with what we have heard from people, which we have fed back to CPFT; we are glad this is reflected in the report.”

CPFT 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.

CQC also rates all services on five key questions and it has rated the trust as Outstanding for Caring; Good for Responsive, and requires improvement for Safe, Effective and Well-led.

Full details of the ratings will be available in due course on the CQC website at:

CQC’s Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said:  “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 and we will continue to monitor the services involved, and to take further action if that is required to protect the interests of patients.”

Dr Lelliott also noted that taking on new services community services “can be difficult”.

The CQC found that not all of the premises were suitable for patient assessment or treatment and 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.

Amanda added: “We are consistently hearing about poor mental health provision and this is something we will be focusing on at Healthwatch Cornwall in 2018.”

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.

“It is good to see staff commitment to caring is acknowledged”, Amanda said, “but for us it is concerning that this puts CPFT and Royal Cornwall Hospital Trust, two major health providers, in a position of needing to improve areas such as safety and leadership.”

“Healthwatch Cornwall will continue to support improvement by ensuring patients’ voices are heard”.

CPFT responded to the report to say it was pleased that the care from staff was upgraded to Outstanding – read their full response: CFT response to CQC Feb 2018 report

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