Agenda item

7.1

The Committee received a report detailing the progress that had been made in relation to the delivery of the Sheffield Health and Social Care NHS Foundation Trust Improvement Plan, following the Care Quality Commission inspection of the Trust in January, 2020 when the Trust received an overall rating of “inadequate”.

7.2

Present for this item were Jan Ditheridge (Chief Executive) and Mike Hunter (Medical Director) (Sheffield Health and Social Care NHS Foundation Trust) and Alun Windle (Acting Chief Nurse, Sheffield NHS Clinical Commissioning Group).

7.3

Jan Ditheridge referred to the questions asked by Jeremy Short and stated that the Trust was truly sorry for the inadequate rating it had received and had written to its members and all members of staff with an apology for what had happened.  She said that an apology had also been made at a public Board Meeting and at a number of other arenas. Jan Ditheridge thanked Mr. Short for pointing out that the link, included in the Trust’s magazine, did not work and said that this would be put right. There were two action plans, one around core services and the other around “well led”.  The Trust had been given tasks and have a number of actions to complete.  Oversight arrangements have been different because of Covid and lockdown, although meetings were held on a regular basis to scrutinise progress against the actions in the action plan.

7.4

Mike Hunter stated that the Trust’s core services had been inspected by the Care Quality Commission (CQC) in January, 2020 and immediately following this inspection, a Section 31 Notice, stating that 16 and 17 year olds should not be admitted to shared accommodation in the Psychiatric Decisions Unit, was served and the Trust took immediate action and complied with the Notice within 24 hours.  In February, 2020, the Trust received a Section 29A Warning Notice, which identified four areas which required significant improvement.  The CQC found issues with staffing, mandatory training, safeguarding, the management of physical health, environmental safety and incident reporting.  The two main areas where there were problems were in Acute Wards and Crisis Services, in that they were inadequate in terms of safety and not well led. Since then, management on a day-to-day and weekly basis had seen significant progress being made, and the CQC have engagement calls on a fortnightly basis to monitor progress.  It had been challenging to adhere to safe staffing numbers on acute wards, and flexibility of working practices was required. The Trust put in place an Improvement Plan, and a “Getting Back to Good Board” meets monthly to oversee and drive delivery of the actions required, which the Trust thinks will take 12 months to implement. All of the urgent actions in the notice have been completed, and the Trust were about one third of the way towards implementing all the actions required.

7.5

Members asked a number of questions, to which responses were provided as follows:-

·                     Staff morale had been hit hard, but the issues have been addressed, although staff felt that they were still in the thick of it.  There still remained a number of staff vacancies.  The Covid 19 pandemic had lifted staff spirits as they worked as a team, were more flexible and volunteered and felt well supported by the team response.  They had proved to themselves that where there were infections they managed to contain the virus very well. 

·                     The Trust still rely very heavily on bank staff and agency nurses, who were very much part of the team.  Bank nurses work regularly, in the same areas, and go through the same training as regular staff.

·                     There were 22 newly qualified nurses due to start at the end of August, 2020, which was a welcomed development.  They are newly qualified and enthusiastic.

·                     Improving Access to Psychological Therapies (IAPT) services continued to grow and change.  The Trust has now appointed more care co-ordinators in its Community Mental Health Teams in order to reduce caseloads and allow for more therapeutic time with patients.

·                     Governance arrangements have been refreshed and data was available to understand where the risks are. The Trust has undertaken a lot of work to build a performance framework and this had been complemented by Board visits and visibility out in the field.

·                     Memory Services perform well in Sheffield and responded well to change.  The services that had slipped were the acute wards and indicators show that the Trust is heading in the right direction and improvements were being made.

·                     There was a distinction between management and practice supervision.  The CQC want to see improvements in practice supervision (reflective practice), getting practitioner leaders to engage with staff more readily.  The Trust have not changed the leaders and managers through the organisation but what has emerged is that there are many layers of management and this was a root cause that has tripped them up.  Leadership programmes were in place but there was room for more. The results being seen are in terms of compliance with supervision and appraisals.

·                     The usual response to an inadequate rating, was that there was an NHS Improvement Management Team established to oversee improvement. Feedback received shows that there had been rapid improvement in some areas.  The Regional Executive Management Team will continue oversight of the Trust.

7.6

RESOLVED: That the Committee:-

(a)       thanks Jan Ditheridge, Mike Hunter and Alun Windle for their contribution to the meeting;

(b)       notes the contents of the report;

(c)        is satisfied with the information provided by the Sheffield Health and Social Care Trust on the CQC Improvement Plan; and

(d)       requests a further report to the Committee in six months on progress, with a focus on how the changes being implemented as a result of the Improvement Plan will improve outcomes and make a difference to Sheffield people.