CDDFT achieves ‘Good’ CQC rating 17 th January 2019 Sue Jacques Chief Executive www.cddft.nhs.net
Contents • Inspection regime • Previous position • Inspection coverage 2019 • Outcomes • Key actions & findings www.cddft.nhs.net
Care Quality Commission The CQC is the independent regulator of all health and social care services in England. They are given powers by the government to regulate, monitor and inspect all health and care services. The CQC inspect based on core services which for CDDFT are; Acute Community ❖ ❖ Medical Care Community health services for ❖ Surgery adults ❖ ❖ Critical Care Community health inpatient ❖ Maternity service ❖ ❖ Children and young people Community health services for ❖ End of life Care children and young people ❖ ❖ Urgent and emergency care Community end of life care ❖ Outpatients Additional services ❖ Gynaecology ❖ Diagnostic Imaging www.cddft.nhs.net
CQC 5 domains They inspect these services against five domains : www.cddft.nhs.net
Previous position • Community Services rated Good • DMH rated Requires Improvement • UHND rated Requires Improvement • Overall Trust rating ‘Requires Improvement’ www.cddft.nhs.net
Coverage - 2019 • Unannounced inspections of: • End of Life Care • Urgent and Emergency Care (A&E) • Surgery • Three day Trust- level ‘Well - Led’ assessment • Separate ‘Use of Resources’ assessment www.cddft.nhs.net
UHND 1. All services good except A&E (same as 2017) 2. End of Life Care now Outstanding 3. Surgery now Good 4. Critical care and Medicine not inspected 5. Overall rating for site = Good www.cddft.nhs.net
DMH 1. All services good 2. End of Life Care now Outstanding 3. Surgery now Good 4. Overall rating for site = Good, same for all Domains www.cddft.nhs.net
Community Services 1. Not inspected 2. Ratings as 2015 3. Trust self- assessment is that there is some outstanding practice to recognise here www.cddft.nhs.net
Sites and Trust ratings 1. Good at all levels 2. Safe Domain is RI because 1 out of 3 sites has RI (UHND) 3. Well-Led rating for the Trust is from the 3 day assessment not aggregated by sites 4. Use of resources rating (separate) is also Good www.cddft.nhs.net
Thanking #TeamCDDFT
Other findings – Outstanding Practice • 20 areas of outstanding practice - End of Life Care - Surgery - Emergency Department “The Trust provided the highest level of end of life and palliative care involvement to dying patients in the region.” “The acute intervention team is an innovative service proving assessment and input to critically ill patients in acute hospitals with the recognition that many of these patients will have palliative care needs.” “The specialist palliative care service has improved personalised care planning and supported preference for place of death for 95% of patients.” “For quarters one to four in 2018/19 the emergency department consistently achieved 100% for sepsis screening. The percentage of patients given antibiotics within an hour had increased from 55% to 93%.” www.cddft.nhs.net
Other findings – Outstanding Practice “The surgical nursing preceptorship support programme has developed to be a national leader in support and preceptorship to help sustain and improve recruitment, retention and staff satisfaction.” “Getting it right first time (GIRFT) visits commended elective orthopaedics and aspects of ophthalmology. “The national emergency laparotomy audit (NELA) results were ahead of average on a number of indicators and the Durham multi-disciplinary team functional bowel service is an award winning nationally recognised service.” “The Trust was among the very best performers nationally for the NELA audit with respect to elderly care review.” www.cddft.nhs.net
Other findings • Nine ‘Must Do’ actions (improvement notices) • 23 ‘Should Do’ actions (recommendations for improvement) • Action Plans in place and work already in progress www.cddft.nhs.net
Must Do Actions • Fit and Proper Persons Test to cover all statutory requirements • Increase the coverage of training in MCA / DOLS • Ensure compliance with training targets for the above • Ensure consistent compliance with policy for syringe driver checks • Ensure consistent compliance with policy for pain assessments / action (end of life care) • Ensure safe and secure storage of medicines in all areas • Continue to strengthen paediatric nursing and medical staffing in A&E Departments • Ensure consistent compliance for Oxygen prescribing with BTS recommendations • Ensure the availability of paediatrics-trained clinicians for children streamed away from the A&E Department www.cddft.nhs.net
Questions www.cddft.nhs.net
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