The Royal Devon and Exeter NHS Foundation Trust has been rated as “good” overall, following an inspection by the Care Quality Commission.
The trust was also rated “outstanding” for services that were caring, and “good” for being effective, responsive and well led. However, safety was rated as “requires improvement”.
“Trust staff should be proud of this achievement”
Urgent and emergency services and critical care at Wonford Hospital were both rated “outstanding” by the regulator in its latest report.
CQC inspectors visited Wonford and the Mardon Neuro-Rehabilitation Centre over a period of four days in November 2015. They concluded that across the trust staff displayed a “clear commitment” to providing patients with high quality care and treatment.
Staff treated patients with dignity and respect, and inspectors were told by patients that staff went out of their way to help and support them. Inspectors witnessed “exemplary” care being given on many wards.
Outcomes for people who used the emergency department were consistently better than expected when compared with similar services, said the CQC. Audits showed performance in the treatment of sepsis and paracetamol overdose was particularly good.
The trust had a strong safety culture and providing safe care was considered a priority for staff at all levels, with learning from incidents widely shared and staff recognising the importance of reporting incidents to ensure patient safety.
Inspectors identified a range of areas of outstanding practice, including that ambulance crews had an agreement with the emergency department that they would radio ahead to tell staff when they had a patient with a suspected broken hip.
This gave nurses time to inflate a pressure relieving mattress for the trolley, meaning ulcers would be prevented but X-rays could still be carried out without moving the patient.
Meanwhile, the care being provided by staff in the critical care unit went “beyond day-to-day expectations”, noted the regulator.
“Our staff are outstanding and deliver exemplary care day in day out”
For example, inspectors saw beds being turned to face windows so patients could see outside. Patients and visitors gave overwhelmingly positive feedback, said the CQC.
The CQC highlighted that Royal Devon and Exeter was one of only three trusts in the country with recognition in achieving the Gold Standards Framework for end of life care, with three wards accredited and one deferred.
Plans to extend the gold standard to further wards demonstrated an outstanding commitment by ward staff and the specialist palliative care team to end of life care, it said.
However, inspectors identified some concerns with the confidentiality of records – not all were kept secure to prevent unauthorised access.
The supply or administration of medicines should also be in line with trust policies and best practice, it warned.
CQC chief inspector of hospitals Professor Sir Mike Richards said: “We found the care was exemplary throughout the trust. We found the care in the emergency department and in critical care services that was outstanding.
“Staff engagement is very good,” he said. “There is a long established and supportive leadership with a clear vision and set of values that staff understand and work towards.
“All of the staff we met on this inspection spoke positively about ensuring that patients received a consistently high quality service and experience,” said Sir Mike.
“Trust staff should be proud of this achievement,” he added.
Trust chief executive Angela Pedder said: “We are delighted to receive this confirmation of the outstanding and good care our staff across the trust deliver for the people who use our services.
“Our staff are outstanding and deliver exemplary care day in day out – on occasions in very trying and challenging circumstances,” she added.