Agenda item

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

a.    CQC Inspection Update from Southern Health Foundation Trust 

b.    CQC Inspection Update from Hampshire Hospitals Foundation Trust 

a. CQC Inspection Update from Southern Health Foundation Trust 

Representatives of Southern Health Foundation Trust provided an update on their upcoming CQC inspection report.  Members heard that there was a delay in publication due to internal CQC issues and it is now expected later in January.  The action plan notes that most actions are complete, and the remaining items will be rolled over into the new plan based on the latest report. 

In response to questions, Members heard:

The CQC criteria for safety include reporting, investigating, physical environment safety, staff training, robust processes for medicine management (temperatures and dates), etc. among others.  Members expressed their concern about patient safety, but also that of the staff.  The Trust anticipates receiving and sharing a positive report very soon.

RESOLVED:

That the Committee-

a. Noted the approach and actions of the Trust to respond to the findings and address areas of concerns.  

b. Requested an update in March 2020.

b. CQC Inspection Update from Hampshire Hospitals Foundation Trust   

This item was taken out of order at the Chairman’s discretion.

Representatives of Hampshire Hospitals Foundation Trust provided an update on their detailed action plan since their last CQC inspection report based on September 2018 visits.  Members heard:

Issues and notices (Section 29a, 31) were served, requiring must do actions.  Systematic progress was made on 229 items, some partial and with continued monitoring of progress.  Notice 31 regarding emergency care was lifted 3 weeks ago.  Further work continues and weekly reports are reviewed regularly.  Building improvements have been morale boosting for staff. 

Better training and awareness for staff has helped in providing care in the right setting for individuals with mental illness, learning disabilities, and autism.  Investing in mental health teams and having a Mental Health Act manager alongside a Learning Disability Liaison nurse has been a positive development.  Equipment maintenance and timeliness issues have been addressed almost completely. 

Governance improvements have been made with regards to complaints, mixed sex accommodation, and accessible information standard.  Well-led improvements have included new changes to the board make-up, sub-committees, the architecture of governance in responding to CQC recommendations and managing risk and risk registers.  Staffing remains the most significant risk currently addressed with agency support and overseas hires.

Culture findings are taken seriously while implementing and modelling values with a current appraisal rating higher than ever before.  Appointing cultural change ambassadors and utilising expertise from external companies have been key to designing and implementing solutions and upgrades from the bottom up.

At the moment, there is an incredible pressure and demand and the CQC is currently looking at 3 core services – surgery, medicine, urgent and emergency care.  Basingstoke and Winchester have CQC visits today and Andover will follow for comprehensive observations with an inspection report expected in April. 

Self-assessment reviews note areas that require further work.  The CQC will see a hospital under pressure with unprecedented demand and increases in usage and challenges whilst providing safe care.

In response to questions, Members heard:

Agency nurses are meeting expectations as they are provided with an induction and work regularly with teams. 

CQC priorities align with those of the Trust but trying to address competing priorities such as finance, operations, quality, and increased pressures on staff remain a challenge.  There are many pressures that need to be addressed and can add strain to the financial envelope.

Approximately 50 formal complaints are received each month, as well as informal ones which are generally resolved within a day.  There has been increased responses, a focus on face to face meetings (not just written follow ups) and links made to lessons learned.  Key themes and work streams are in place to continue to address concerns. 

Previously, the assurances were not as robust as they could be.  The Trust perhaps hadn’t been sighted? on certain areas and performance, demand, activity pressures which would have had knock on effects.  There is debate about accuracy in the judgment of self-assessments which are not always straightforward.  The Trust would be pleased to see alignment between self-assessments and CQC observations. 

Indicators suggest that best practices are being followed, and cultural changes are taking place with staff at all levels encouraged to share feedback via several channels which are reviewed regularly. 

RESOLVED:

That the Committee-

a. Noted the approach and actions of the Trust to respond to the findings and address areas of concerns.  

b. Requested an update in May 2020