09 Jan to 08 Mar 2019
During an inspection of Community end of life care
Our rating of this service improved. We rated it as good because:
- We rated safe, effective, caring, responsive and well-led as good.
- The trust now had an end of life strategy and staff documented and monitored patients’ medical care through the use of care plans.
- The service provided mandatory training in key skills to all staff and made sure everyone completed it.
- Staff were given time to reflect and review their practice and this was recorded in a workbook to demonstrate skills, knowledge and competencies supporting NMC revalidation.
- The service controlled infection risk well.
- Records we looked at showed that assessments of patients’ needs were recorded to minimise their risks and maximise their comfort.
- The service now provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
- A staff supervision strategy was now in place to support staff in delivering high quality, safe care.
- The service now monitored the effectiveness of care and treatment and used the findings to improve them. They compared local results with those of other services to learn from them.
- Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
- Staff provided emotional support to patients to minimise their distress. Families and patients unanimously told us that the staff were all caring and thoughtful.
- Patients’ individual needs were now appropriately planned and risk assessed.
- Concerns and complaints were taken seriously, investigated and lessons learned from the results, which were shared with all staff.
- A wealth of complimentary cards and letters, received from relatives, were displayed in the community wards.
- Managers had the right skills and abilities to run a service providing high-quality sustainable care. Leaders were visible and approachable.
- Staff now felt engaged and valued. The leaders had become fully engaged with regards to promoting the strategy. The drive and commitment was evident to all staff involved with the process.
- Managers promoted a positive culture that supported and valued staff.
- The service had effective systems for identifying risks.
- The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.
However:
- The service should ensure progress is made in the implementation of electronic prescribing for prescriptions with the necessary security safeguards.