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During an inspection of Community health services for adults
We carried out this focused inspection because we had concerns about the quality of services. The inspection was focused on the management of wound care within the Hull and East Riding community nursing service. The inspection did not look at other services provided by City Health Care Partnership or other areas of the community nursing service.
City Health Care Partnership is a co-owned independent community healthcare service providing a range of community services in Hull, the East Riding of Yorkshire, Knowlsey and St Helens. Community nursing services within Hull and East Riding are delivered from three main bases at Bransholme health centre, Longhill health centre and Priory Park health centre. During this inspection we visited the bases at Longhill and Priory Park health centres.
This was a focused inspection, so we did not re-rate the service. The service was last inspected in November 2016 and the existing rating of good remains in place. We did not identify any required enforcement action during this inspection. We found:
- Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration
- The service managed patient safety incidents well. Staff recognised incidents and near misses and reported them appropriately. Managers investigated incidents and shared lessons learned. Managers ensured actions identified from investigations were implemented and monitored.
- The service provided care and treatment based on national guidance and evidence-based practice. Staff monitored the effectiveness of care and treatment. They used findings to make improvements.
- Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Staff had access to specialist training and support from professional leads and practice teachers.
- The service operated effective governance processes. Performance and risk were managed well. Staff were clear about their roles and accountabilities and had opportunities to meet, discuss and learn from the performance of the service.
However:
- Although policies, procedures and guidance documents reflected up to date best practice not all guidance documents had issue dates, version numbers or review dates.
How we carried out the inspection
This was a focused inspection and we did not inspect against all of the key lines of enquiry or against all five key questions. This inspection focused on elements of the safe, effective and well-led key questions. We did not inspect against the caring or responsive key questions.
We gave the service a short period of notice the day before the inspection visit as we needed to ensure staff would be available to speak to us within the community hubs.
Before the inspection visit, we reviewed information that we held about the service. During the inspection visit, the inspection team:
- visited two community hubs, one of which included a treatment room;
- spoke with seven patients who were using the service;
- spoke with eight nursing staff, two professional leads and a clinical project lead;
- spoke with three other senior managers;
- reviewed 11 care and treatment records;
- observed seven patient appointments;
- observed two operational meetings; and
- looked at a range of policies, procedures and other documents relating to the running of the service.
You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.