The Care Quality Commission (CQC), the independent regulator of health and adult social care in England, has today (Thursday 17 December) published its inspection reports for Somerset Partnership NHS Foundation Trust following a week-long planned inspection in September 2015 and a series of further unannounced inspections.
The overall Trust rating of ‘requires improvement’ was determined after the quality regulator inspected 17 core services, giving each service an individual rating on the scale: ‘outstanding’, ‘good’, ‘requires improvement’ , ‘inadequate’. The CQC also gave an overall rating for the Trust based on the 17 service ratings.
Overall, the CQC gave the following service ratings:
- 8 services were rated ‘good’
- 8 services were rated ‘requires improvement’
- 1 service was rated ‘inadequate’. This was for community services for adults with learning disabilities.
Consequently, Somerset Partnership was given an overall rating of “requires improvement”.
During the inspection the CQC found a caring, enthusiastic and committed workforce that treated patients with dignity and respect. The CQC report also found that the great majority of patients interviewed reported they were happy with our staff and services and the care we provided.
While the inspectors found many examples of good practice, there were also areas where the Trust needed to improve.
The main areas of concern for the Trust overall were concerns in the community services for adults with learning disabilities and staff shortages (a national problem , shared across the NHS) in the Trust’s district nursing services.
Somerset Partnership Chairman, Stephen Ladyman, commented on the report and said:
“We welcome the CQC’s inspection of our services. As the report states, we have embraced the process openly and honestly at a time when the Trust was undergoing significant organisational change and service re-design.
“I am very proud that the quality of our care has been rated “good” and I want to thank all Trust staff whose hard work and commitment to providing excellent patient care, this reflects.
“The CQC highlights some important areas where we need to improve and puts the onus on us to accelerate our programme of change to address these concerns. As the report makes clear, the Board recognises what we need to do and we are confident that we will make the required improvements and use the report as a platform for change.”
On concerns with community mental health services for people with learning disabilities, Somerset Partnership Chairman, Stephen Ladyman said:
“As soon as we received notification of the CQC’s concerns about our learning disability services, we took immediate action. We wrote to all service users and their carers to explain what had happened and what action we were taking to improve the service. We are taking the warning notice extremely seriously and the CQC has recognised that we have already made significant improvements. We acknowledge there is more work to do.
“We recognise that our services for people with learning difficulties have not been consistent in the way we record risk assessments and complete care plans but equally it is important that feedback from patients and carers has been positive and CQC inspectors found staff caring and compassionate. However, the requirements of modern healthcare provision and the complex needs of our patients require our staff not only to provide good quality care but to record every decision about care planning, to consider all possible risks to patient care and to document all risks and mitigations and we are taking all the appropriate steps to make sure the service consistently meets these requirements.”
On concerns with the district health services, Somerset Partnership Chairman, Stephen Ladyman said:
“The Trust is very conscious of the pressures on our district nursing services: we have already seen an 8.8% increase in demand for the district nursing service from April – June 2015, that is more than 7,000 extra patients over the first quarter of the financial year alone. As well as the increase in patient demand, there is also an increase in the complexity of these cases: more and sicker patients suffering from a range of more complex long term conditions which have a greater impact on nurses’ workloads. While the Trust has been effective in the national and local drive to move care from hospital beds to patients’ homes, health resources have not always followed the patient. We continue in our discussions with our commissioners, and our primary and acute care partners on how to better resource Somerset’s district nursing service.”
On areas the CQC identified as good practice, going above and beyond what was expected, Stephen Ladyman, Chairman, said:
“I am pleased the CQC identified many areas of good practice in the Trust. Our staff pride themselves on their innovation and commitment to excellent patient care. The CQC states in their report that our staff are kind, caring, compassionate and enthusiastic, and treat patients with dignity and respect. We are proud of our work too, with carers, and through our commitment to the Triangle of Care and our carers’ charter, giving them an equal role in and affording them respect for the care they also provide to our patients.
“The CQC also noted our good working relationships with voluntary organisations and our engagement with national research projects. Some of our staff engagement work, which has won national recognition, is also highlighted in the CQC report.
“We are also pleased that the CQC recognised the support that we provide patients at the very end of their life, in helping them to fulfil their ultimate wish to die in their own home.
“As a Board, we are committed to creating an environment where staff are encouraged to innovate and fulfil their ambitions to develop and improve the care we provide. By creating a culture which embraces excellence and is courageous enough to learn from mistakes, our Trust can become an outstanding example of quality patient services."
Somerset Clinical Commissioning Group’s Director of Quality, Safety and Governance, Lucy Watson, commented on the CCG report and said:
“Somerset Clinical Commissioning Group (CCG) has been working closely with the Somerset Partnership NHS Foundation Trust since the Care Quality Commission's inspection and supporting the Trust to make the improvements required in response to the concerns raised by the CQC about Learning Disability services.
"We acknowledge the open response of the Trust to the findings from the CQC's inspection and their commitment to learn, improve and accelerate improvements to the way services are provided and the Trust recognises the need for better staff engagement.
"We also welcome the focus from the CQC on the need for greater partnership working by the Trust and engagement across the health and care community in order to accelerate improvements to services. This supports the approach of the CCG to service transformation and the need for strengthened partnership working between NHS Trusts, primary care and social care providers if we are to deliver the integrated and personalised care that we all wish patients to receive."