The Care Quality Commission has today published a report on services at Northern Devon Healthcare NHS Trust, following their inspection in May 2019.
The inspection looked at urgent and emergency, maternity, end of life and outpatients services at North District Devon Hospital and community inpatients services at South Molton.
The report recognises that there have been significant positive changes since their last inspection in October 2017.
- End of life care services and outpatient services are now rated ‘good’ from previous ratings of ‘requires improvement’ and ‘inadequate’
- The Trust maintained an overall rating of ‘good’ for ‘are services caring?’, with high scores across all services
- Improvements in maternity delivered an improvement in the scoring for well led, going from ‘requires improvement’ to ‘good’
- Community inpatients maintained their ‘good’ overall rating
- Inspectors recognised the improvements that have been made in the emergency department environment.
- Inspectors highlighted many examples of outstanding practice across the Trust, including in urgent and emergency, maternity, end of life and outpatients services
- Inspectors found “an exceptionally strong patient-centred culture with staff putting patients first to keep them safe and involving them in decisions which affected their treatment and care”
Whilst the report recognises the positive change at the Trust, the CQC has kept the overall rating as ‘requires improvement’.
Suzanne Tracey, chief executive, said: “Whilst we would really like to see our overall rating improve, the report is clear that we are in a very different position today compared to the previous inspection.
“Every member of staff has worked incredibly hard to improve our services, and it’s clear from the report that we are providing better care for our patients as a result.
“We have made improvements across all areas, and I am confident that we are heading in the right direction and are doing the necessary work to develop sustainable future plans for our services.
“We are very proud of our services and we look forward to welcoming the CQC back in the future so they can see how our journey is progressing.”
The CQC’s report will be available in full at https://www.cqc.org.uk/provider/RBZ
Urgent and emergency services (requires improvement)
- “The cleanliness of the department had improved greatly.”
- “Staff treated patients with kindness and compassion. Staff ensured patients were involved in decisions about their care. Patients were positive about the care they received in the department.”
Maternity (requires improvement)
- “Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.”
- “The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well.”
End of life care (good)
- “Care for patients approaching the end of their life was provided with compassion and respect. Staff made sure patients and those close to them understood their care and treatment. Relatives and carers were involved in discussions about the plan of care.”
- “It was apparent during our inspection that all the staff had the patient and their families at the centre of everything they did. They were passionate about end of life care and were dedicated to their roles and approached their work with flexibility.”
- “Staff were conversant with managing people who may be suffering with sepsis and ensuring they received appropriate treatment.”
- “The service had improved some referral to treatment times.”
- “Development of staff was a priority for the service. Staff were competent in their roles, attended mandatory and specialist training to enhance their skills.”
Community inpatients (good)
- “Staff worked together as a multi-disciplinary team and had the necessary skills, knowledge and experience to deliver effective care, support and treatment.”
- “Standards of cleanliness and hygiene were maintained and there were reliable systems in place to prevent and protect people from healthcare associated infections.”
In urgent and emergency care, a consultant has designed a model to assist in the teaching for doctors and nurses of how to treat a traumatic cardiac arrest. The simulation device has been published and presented at conferences.
In maternity, the organisation and implementation of staff cohort team building away days, led by the leadership, has contributed to a large improvement in staff culture and communications. These activities have also led to the formation of the new model of maternity care, which was a direct result of staff idea generation.
In outpatients, prescribing systems for use of systemic anti-cancer treatments have reduced the chance of errors. Work is being undertaken to lead the way in improving the safety of systems when cytotoxic medicines are administered.
The creation of the Snug on Lundy Ward has provided patients and their families and/or carers with a more private, welcoming and dignified space when most needed.
The team of end of life companions has been set up to provide emotional support and comfort for people who are dying, and for their families and/or carers.
The safeguarding team has shown outstanding innovation, multidisciplinary working and external engagement with other stakeholders.
The estates team has shown innovation in developing the boiler room to save £700,000 a year on energy, which is reinvested in the Trust.