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Chief nurse helps mental health trust achieve 'outstanding' rating

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Nursing staff and leaders at Hertfordshire Partnership University Foundation Trust have been praised for their care and dedication after the trust became one of only a handful of mental health providers to achieve the top inspection rating.

The trust, which provides mental health and learning disability services in Hertfordshire, Buckinghamshire, Essex and Norfolk, was rated “outstanding” overall after inspection visits in February and March this year.

“Achieving this highest rating is a real testament to the hard work of all the trust’s staff and its leadership”

Lynne Wigens

The achievement makes the trust one of only five mental health and learning disability trusts in England – and the only one in the East of England - to gain the top Care Quality Commission rating.

Inspectors said they were particularly impressed with the “strength and depth” of leadership at the trust and the report highlights the key role of chief nurse Jane Padmore, who is also director of quality and safety.

“Staff consistently and particularly praised the chief executive, medical director and chief nurse,” said the report, which highlighted the trust’s “person-centred culture”.

The report found “staff felt respected, supported and valued” and “staff morale across all teams was consistently high”.

The organisation also ensured staffing levels and skill mix “were planned, implemented and reviewed to keep people safe at all times”.

Inspectors, who rated the trust “outstanding” for being caring and well-led, were full of praise for staff and said they found examples of outstanding practice in all the core services they visited.

Tom Cahill

Tom Cahill

Tom Cahill

“Staff showed caring, compassionate attitudes, were proud to work for the trust, and were dedicated to their roles,” said the report.

Throughout the trust “staff treated patients with kindness, dignity and respect” and “showed strong therapeutic relationships with their patients and clearly understood their needs”, it added.

The report said there was a “clear proactive approach” at the trust to seeking out and embedding new and more sustainable models of care.

One example was the introduction of a series of new care pathways on the trust’s ward for children and young people, which had reduced the average length of stay from 80 days to just 15.

This had seen staff work closely with community and crisis teams to ensure young patients were supported through the admission process and work with a home treatment team to ensure young people “did not spend any more time in hospital than was necessary”.

“Staff treated patients with kindness, dignity and respect”

CQC report 

Areas of outstanding practice highlighted by inspectors include the trust’s “commitment to supporting staff and learning from incidents to improve patient safety”.

This was backed by a range of initiatives including the use of safety huddles, Swarms and Schwartz rounds.

The trust had also introduced a weekly “moderate harm panel” to discuss any reported incidents of moderate to severe harm or death and share lessons learned, attended by safeguarding and safety leads, clinical directors and deputy directors of nursing among others.

“We considered the trust had had significantly improved practice in this area, reporting had improved and lessons had been learnt that would otherwise have been missed,” said the report.

Inspectors also flagged up the trust’s innovative data management systems, including a system for staff training and supervision, and the fact the trust had introduced “virtual meetings” in order to “save staff travel time”.

Other areas of outstanding practice included the fact patient groups had been involved in re-designing key resources including simplified care plans and information leaflets for new patients and their loved ones.

A young person’s council had helped patients get involved in staff recruitment and met with senior management to discuss changes to child and adolescent mental health services.

In community mental health services for adults “managers ensured staff had caseload sizes depending on their level of experience, other duties and seniority”.

They found multi-disciplinary community teams deployed a wide range of specialists to meet the needs of patients including social workers, drama therapists, art therapists and peer support workers, as well as doctors and nurses.

Meanwhile, inspectors said they were “particularly impressed” with the work of the modern matron for acute adult wards at the trust’s Albany Lodge inpatient unit in St Albans.

“The challenge now is to make sure our service users and their carers continue to receive outstanding care”

Tom Cahill 

“The matron had endorsed rigorous development opportunities for healthcare assistants and put in place clear changes as the result of a death on the ward,” said the report.

CQC inspectors did identify a number of areas for improvement and said the trust needed to take immediate action to rectify a minor breach of legal requirements by ensuring staff on wards for older people with mental health problems received regular, good quality supervision.

The trust was rated “good” for safety, responsiveness and being effective.

Of the 11 services inspected, seven were rated “good” and four were rated “outstanding” - forensic inpatient or secure wards, child and adolescent mental health wards, wards for people with a learning disability or autism, and community-based mental health services for adults. 

Lynne Wigens

Lynne Wigens

Lynne Wigens

Trust chief executive Tom Cahill said securing an overall “outstanding” rating was “a fantastic achievement for everyone working for the trust”.

“Of course, there is more that we need to do because that’s always the case,” he added. “The challenge now is to make sure our service users and their carers continue to receive outstanding care at a time when demand continues to grow.”

Lynne Wigens, chief nurse for NHS England and NHS Improvement in the East of England, also praised the work of staff and leaders. 

“I am delighted to see the efforts of the team at Hertfordshire Partnership University NHS Foundation Trust have resulted in an ‘outstanding’ rating from the CQC,” she said.

“Achieving this highest rating is a real testament to the hard work of all the trust’s staff and its leadership, and will provide confidence and reassurance to the patients and community in the standards of care provided,” Ms Wigens added.

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