NELFT can confirm the publication of the Care Quality Commission’s (CQC) report into our services following the latest inspection. The CQC has issued NELFT an overall rating of ‘Requires Improvement’.
Inspectors visited the trust during May and June 2019 to check the quality of eight core services and to carry out the well-led review.
As a result of this inspection the Trust has now been rated ‘Requires Improvement’ overall. For caring effective and responsive the Trust was rated as ‘Good’. For safety and well led it was rated as ‘Requires Improvement’..
Professor Oliver Shanley OBE, interim NELFT chief executive, said “This is disappointing news for us given our previous rating of ‘Good’. However as an organisation focused on continuous improvement it offers us an opportunity to reflect and take forward learning and good practice across the Trust.
“The CQC have said the inspection was “one of great contrast”. It is important to recognise no improvement journey is ever linear and although the CQC has highlighted areas for improvement, they have also highlighted many areas of good practice.”
Key areas of focus for improvement include:
- A continued focus on staff engagement and improving the staff experience for some professional groups.
- Pressure on the acute inpatient mental health pathway and impacts on quality and safety of patient care as a result.
- Workforce challenges particularly in Kent Child and Adolescent Mental Health Services (CAMHS) and the acute inpatient mental health care pathway.
- Improving the cohesion in the senior executive leadership team.
The CQC reported examples of outstanding practice in four services they inspected:
- Forensic inpatient/secure wards (low secure)
- Wards for people with a learning disability or autism
- Community-based mental health services for people with a learning disability or autism
- Specialist community mental health services for children and young people
In fact NELFT have achieved ‘Outstanding’ ratings across seven elements of our core services compared to four previously. This is a reflection of the hard work and commitment to delivering the best care.
The CQC were positive about many areas of service provision and key programmes of work across the Trust, highlighting the following:
- The Trust continued to progress its work on equalities, diversity and human rights. This included the ongoing development of staff networks and work to improve the Trust’s performance in relation to the Workforce Race Equality Standard.
- The Trust’s use of technology to support mobile working was impressive, along with the increasing innovative use of digital technology to meet the needs of patients and staff.
- The extended reach of the Trust’s programme of quality improvement and the impact this is having on staff engagement in improving services.
The CQC said the Trust promoted the involvement of patients and carers, and across services, staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. Inpatient wards and community bases were clean, well equipped, well furnished, well maintained and fit for purpose. The Trust had systems in place to safeguard patients from abuse and the services worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff had easy access to clinical information and it was easy for them to maintain high quality clinical records – whether paper-based or electronic. The Trust managed patient safety incidents well. Staff recognised incidents and reported them appropriately.
Professor Shanley added: “I know this news will be disappointing for our staff and stakeholders but I would like to reassure you we are already taking action to make improvements in the areas highlighted. Our staff are committed to delivering the best care to the communities we serve and I know we will continue to work hard on our journey towards delivering outstanding care across the Trust.”
Jane Ray, CQC’s Head of Hospital Inspection (and lead for mental health), said: “The inspection of North East London NHS Foundation Trust was one of great contrast. On the one hand we inspected some outstanding services that were going the extra mile to meet the needs of every patient. On the other hand, we saw services where the care was unsafe. The services for adults who needed acute inpatient mental health treatment were under extreme pressure. This impacted on the safety and quality of patient care.
“The Trust had made some progress with many of the areas identified at the last inspection. This included an extensive consultation and the launch of the trust strategy which was now embedded into the ongoing work of the organisation. It was also good to note the progress with visits to services by non-executive directors with arrangements for them to share their feedback. Governors were offered more opportunities to be included in aspects of the trusts work which supported them to undertake their role.
“However, a combination of new concerns and previous issues still needing to be fully addressed meant the trust’s overall rating has moved from Good to Requires Improvement.”