A trust providing community health services in Wigan has been told it needs to improve.
Inspectors from the Care Quality Commission (CQC) visited Bridgewater Community Healthcare NHS Foundation Trust and gave it an overall rating of “requires improvement”.
They gave “good” ratings for the service being caring and responsive, but the lower rating of “requires improvement” for services being safe, effective and well-led.
The trust was last inspected in 2014 in a pilot project and was not rated, but recommendations were made including improvements to incident reporting and safeguarding training for staff.
The CQC’s report said: “It was evident that the trust had sought to address the findings of our last inspection and improvements had been made in some areas. However in some cases progress in making the necessary changes was slow with a lack of consistency across the trust and services.
“Some services required further improvement and were still not meeting targets, such as those for the healthy child programme, the development of the end of life strategy and the implementation of consistent IT systems across the trust.”
The CQC found staffing had improved in the community, but there were concerns about the number of staff in services for young people.
Waiting times in the community adults and the children, young people and families service had improved in some areas but not all.
The trust’s medicines strategy expired in 2013, there was unsafe practise regarding the prescribing of end-of-life medication and the governance systems needed to be improved.
In urgent care services, including Leigh walk-in centre inspectors observed staff being kind and compassionate but they also said triage systems needed review.
Patients were treated with “kindness, dignity and respect” and 97 per cent would recommend services provided to their friends and family.
Areas of “outstanding” practice included the matrons in Wigan working with the ambulance service to use community care pathways.
This sees a yellow folder containing a patient’s care plan, medical history and medication left next to their telephone and an alert when the patient rang for an ambulance to identify they were on the pathway.
An initiative by Bridgewater and the ambulance service was said to be “the highest performing admission avoidance pathfinder initiative within the North West.”
However, there were also areas of poor practice where improvements were needed.
These included making sure the medicines strategy was up-to-date, ensuring patients were triaged in line with national guidance and having a trust-wide vision for end-of-life services.
Bridgewater provides community health services and is based on Smithy Brook Road in Goose Green.
Its chief executive Colin Scales said: “I’m proud and delighted that the inspectors have rated our services as caring without exception and that the report has highlighted the compassion and dedication of our staff and the difference they make providing care to patients every day. I’m really pleased they have been publicly recognised for this and that our outstanding clinical practice has attracted the praise it deserves.
“We’ve matured as an organisation since our establishment in 2011 and have a new chief nurse and medical director who will be focusing on improving and developing our diverse services across the region.
“Our commitment is to ensure that our standards are high across each and every service and that we move on a journey towards being a trust that is rated as good and then outstanding.
“All the essential actions the CQC has asked us look at have already been addressed since the inspectors were on site, so we’ve made a lot of progress and are in a stronger position now as we move forward.”