Our services have been rated ‘good’ in all five areas assessed by the Care Quality Commission, following an inspection in June 2018.

The latest report shows an improvement on our inspection in 2014, with a clean sweep of green and many areas of outstanding being recognised, maintaining our overall 'good' rating.

Matthew Winn, Chief Executive said: “I am delighted that the Trust and the services our staff deliver have been rated as ‘good’, with many examples of outstanding practice being recognised. These ratings reflect the dedication and professionalism of our staff and the phenomenal programme of service improvements, which have taken place across our regional services in the last few years. All of this contributes to us providing high quality health services that improve the outcomes for local residents.”

Responding to the report’s findings, Julia Sirett, Chief Nurse added: “Quality is at the heart of everything we do; and to be rated ‘good’ for the safety, effectiveness, responsiveness, care and compassion of our services is a credit to our amazing staff.” 

Matthew Winn concluded:  “The Trust’s overall leadership, management and governance arrangements were also rated ‘Good’; which is excellent news for local people given the strong link between these and the quality of services delivered.

“The CQC team did identify a small number of areas where we can improve and these have either been addressed or are in the process of being addressed.  

“I would like to take this opportunity to thank each and every member of staff across our regional services for their hard work, without which we would not have received such fantastic ratings.” 

Summary of outstanding areas identified

• Our dental services were rated as ‘Outstanding’ for ‘Caring’ – including some staff learning Makaton and simple British sign language to improve communications
• the Luton respiratory team interventions reducing the prevalence of TB locally by 10% per year in the last three to four years
• introduction of The Think Pink campaign in Luton (including a pink wristband) which is ensuring patients already known to community services receive speedy resumption of services on discharge from hospital or avoid a hospital admission altogether
• The Luton community discharge team working closely with the hospital and GPs to anticipate patients who may need additional support before discharge and to triage GP referrals to help avoid unnecessary admissions.
• The Oliver Zangwill Centre was commended for its involvement in a number of innovative practices including the development of an external memory aid ‘NeuroPage’
• Each of the Trust’s Board meetings include a patient story to set the tone of the meeting and staff were invited to have lunch with the Board following the meeting

Are services safe

• There was a good incident reporting culture. Incidents were investigated and lessons learned were shared as appropriate.
• Compliance with mandatory training was good. This was an improvement since our last inspection when compliance with mandatory training was poor.
• Staff protected patients from abuse and the service worked well with other agencies to do so. Staff were trained on how to recognise and report abuse, knew how to respond, and were well supported by the safeguarding team.
• Staff had the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• There were still staff vacancies in community health services for adult teams (Luton) but this had improved since our last inspection in May 2014. Staff were flexible in their approach to work and managers proactively ensured there were sufficient staff on duty.

Are services effective?

• Care was provided in line with national guidance. Managers checked to ensure staff followed guidance as part of regular supervision and audits.
• There was effective monitoring and findings were used to improve. Findings were compared to other services to enable learning.
• Staff were competent to undertake their roles and managers appraised staff’s work performance and held supervision meetings with them, to provide support and monitor the effectiveness of the service.
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005. They knew how to support patients experiencing mental ill health and those who lacked the capacity to make decisions about their care.
• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

Are services caring?

• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. This was particularly evident in the community dental service where dental staff took time to get to know patients holistically and provided care that was person centred.
• Staff involved patients and those close to them in decisions about their care and treatment.
• Staff provided emotional support to patients to minimise their distress.
• Feedback was consistently positive and Friends and Family Test results were good overall.

Are services responsive?

• Patients’ individual needs were considered when planning services.
• People could access the service when they needed it. Waiting times from referral to assessment were in line with good practice.
• Concerns and complaints were taken seriously, investigated and lessons learned from the results, the Trust had acted on negative patient feedback, made changes and shared findings with all staff.

Are services well-led?

• The board had the skills, knowledge, experience and integrity to lead the Trust. The Trust board members were a group of individuals with a wide range of experience, knowledge and skills who displayed transparent accountability at decision making levels.
• The executive team were a stable cohesive team, focused on patient safety and quality of care. They were dedicated leaders with clear strategic vision and commitment to staff engagement.
• The board and senior leadership team recognised the training needs of managers at all levels, including themselves, and worked to provide development opportunities for the future of the organisation.
• The board and senior leadership team had set a clear vision and values that were at the heart of all the work within the organisation. They worked hard to make sure staff at all levels understood them in relation to their daily roles.
• The board were aware of the continuing pressures on the health system and the challenges this presented to quality and sustainability. There was a strong focus on working collaboratively with local partners, acute and social services and external organisations to move forward sustainability and transformation plans.
• Board members were visible across the trust and without exception, staff fed back that senior leaders were visible and approachable.
• The board reviewed performance reports that included data about the services, which service leads could challenge.
• Staff throughout the core services we inspected told us the Trust promoted a ‘no blame’ culture and they were encouraged to raise concerns and report incidents without fear of retribution.
• The Trust's overall staff engagement score was the best for community trusts and ninth best nationally at 3.97 compared to the 3.78 as the national average for community trusts.
• The Trust was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation.
• Leadership development opportunities were available, including opportunities for staff below team manager level.
• The Trust actively supported leadership development through further training and planned for career succession.
• Leaders across the trust generally promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff we spoke with throughout our core service and well led inspection told us they felt positive and proud about working in the Trust and their team. Staff told us they felt empowered to make decisions and to make changes.

Areas for improvement

Trust-wide

• The Trust should improve the time taken to resolve complaints in line with its own policy.

Adult community services – Luton

• The Trust should ensure it revises its clinical waste disposal policy and that staff follow the correct procedure for the disposal of clinical waste in patient’s homes.
• The Trust should ensure that community nursing staff have time scheduled for daily handover meetings.

Community dental services – Cambridgeshire and Peterborough

• The Trust should review the storage of patients’ dental care records to ensure they are held securely and confidentially at the Brookfields location.
• The Trust should review the process around medicine management and daily medicine fridge temperature monitoring, to improve consistency across the whole service.