Hertfordshire Community NHS Trust has seen its rating upped from “requires improvement” to “good” by the Care Quality Commission, following its latest targeted inspection.
The regulator carried out a comprehensive inspection at the trust in February 2015, when it was rated as needing to improve, especially on staffing levels and skill mix.
“Staffing levels, skill mix and caseloads were planned and reviewed”
Inspectors returned in April this year to check on progress with improvements to community health services for adults, the community inpatients service and the community end of life care service.
While there was still some work to be done particularly in relation to end of life care, the trust had worked hard on improving all three of these core services, according to the CQC’s latest report.
As a result, the regulator said today that the trust was now rated as “good” overall. However, inspectors said the trust must make a number of further improvements in end of life care.
These included that the trust should embed the nation individualised care plan for the dying person into the service and that patient care records should be completed with all required details.
“HCT’s doctors, nurses and other healthcare staff are a hidden army”
The trust should also ensure staff collected information about patient wishes for their preferred place of care, place of death and the percentage of patients who were able to die in their preferred place of care, so the information could be used to improve the service.
In addition, the trust should undertake audits to monitor compliance with the management of pain relief and the use of opioids in palliative care, ensure that all patients have access to their required medication as required and that controlled drug checks were completed in line with requirements.
Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “We were encouraged by the improvements made following our last inspection.
“Since our visit in 2015 the trust has made improvements to its staffing levels and introduced a variety of measures to attract and retain staff,” he said.
Sir Mike Richards
Sir Mike added that it had made improvements to how it ensured children and adults were protected from the risk of harm or abuse, and that staff understood their responsibilities to raise concerns, record and report safety incidents, concerns and near misses.
He also highlighted that the inspectors had found the trust had addressed previous issues surrounding workloads.
“Staffing levels, skill mix and caseloads were planned and reviewed so that people received safe care and treatment and there were arrangements in place for supporting and managing staff,” he said.
“Inspectors found staff to be dedicated, kind, and caring and leaders understood the challenges of good quality care and supported to staff to ensure this was provided,” said Sir Mike.
But he noted “there are still some areas where change is needed”. “The leadership knows what it must now do and we are confident that the executive team, with the support of their staff, will work to deliver these improvements on behalf of all of their patients,” he said.
The trust provides healthcare services to people living in Hertfordshire and as well as children living in West Essex.
Herts community provider has improved says CQC
It provides community-based services for adults and older people, children and young people, and a range of ambulatory and specialist care services.
David Law, the trust’s chief executive, said the latest CQC findings highlighted “what we already knew, that our frontline staff provide great care”.
Clare Hawkins, chief nurse and director of quality and governance at the trust, added: “Each year HCT healthcare staff make 1.8million contacts with the people who use our services.
“Every patient should be assured that the care they receive is good, and in many cases outstanding,” she said.
The trust noted in its response to the CQC report that it had begun a planned campaign to promote its end of life care policy in May, a month after the inspection.