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Agenda item

Care Quality Commission Inspection Update - Sheffield Health and Social Care NHS Foundation Trust

Verbal update will be given at the meeting, and slides will be circulated in advance.



The Committee received a presentation giving an update on the inspection carried out by the Care Quality Commission of the Sheffield Health and Social Care NHS Foundation Trust.




Present for this item were Jan Ditheridge, Chief Executive, Sheffield NHS Health and Social Care Foundation Trust and Dr. Mike Hunter, Executive Medical Director, Sheffield NHS Health and Social Care Foundation Trust.




Dr. Mike Hunter highlighted the main points in the presentation, outlining in particular, the improvements that have been made. He stated that due to improved staff training, appraisal and supervision, there was greater consistency of care on wards keeping patients much healthier and safer during their stay in hospital, particularly on older adult wards.  Dr. Hunter said that focused improvements on wards for people with learning disabilities and autism, had been the removal of dormitories, providing better dignity and safety, and the adult wards had changed to single gender wards.  The Care Quality Commission (CQC) had said that the Trust was heading in the right direction, that leadership arrangements had improved and the Trust was providing kind and compassionate care, but there was no room for complacency as there was still much more work to be done.  He said buildings were not in great shape and plans were underway to build new facilities and work was being carried out with staff in social care and housing organisations to provide the right accommodation and housing for those with mental health problems when discharged from care.  He stated that mental health issues had significantly increased over the last 18 months and whilst recruitment plans were in place, it was still difficult to get the best qualified nurses in post.




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




·                There was a renewed commitment for smoke free hospitals and there was a major drive to make vapes readily available to those who were detained in hospital and were addicted to nicotine. The combination of replacement of nicotine and training of staff, has meant that some who enter the ward as a smoker, could possibly leave as a non-smoker.




·                The normal practice on hospital wards was for medication to be written up on drugs cards and dispensed by staff. In some short stay settings, it had been found to be beneficial if a patient was admitted with their own medication, they should continue to take it.




·                The Unit at Firs Hill was a seven-bed crisis unit for people who require long-term care and with no discharge plan, but this was type of unit doesn’t fit with modern effective care. The Service at the unit was currently paused so that recruitment can take place to a number of vacancies that have arisen.  The Unit focuses on specific interventions with time limited and measurable outcomes, so patients weren’t staying there for protracted periods of time.  Discussions were taking place in the short term to try and bolster community placement and crisis care. 




·                With regard to the implementation of single rooms, this was to ensure that there was no sharing of space, although it possible that someone could be in a dormitory, which wasn’t ideal as there could be a feeling of solitude. Previously, there had been mixed wards, now there was a male ward and a female ward.




·                A lot of work has been done across the board around safeguarding, due to staff employed within the Trust, would be working amongst vulnerable people. Some learning events with local authorities and other partners have been carried out so that staff can reenergise and refocus on this matter.




·                It was acknowledged that people from different cultural backgrounds don’t always get the same level of care as those from a white background, particularly around retention and in-patient admissions.  It would appear that patients of BAME backgrounds would be detained in hospital for longer and restraint seemed to feature in their care plan. Staff at levels 3 to 6 were representative of  communities in Sheffield culturally, so often people from BAME backgrounds would be cared for by someone from the BAME community.  However, that was not always the case at leadership levels and whilst this was acknowledged, work to change this would be carried out although this would take time.  There was still a lot of work to do to make things culturally appropriate.




·                Work was ongoing with ethnically diverse groups and it was felt there was a need for more diverse people to be involved on interview panels.   In the north of the City, Sheffield IAPT Improving Access to Psychological Therapies (IAPT) has a good reputation and people have good experiences of that Service being accessible to everyone with different backgrounds.  Sheffield was one of a number of early implementor sites, taking expertise in secondary care and weaving that expertise into primary care networks in its services. By April next year, early intervention sites will be accessible and on offer in half of Sheffield, which if something can be done fresh and approached in the right way, services can be more accessible.




·                Training was available for nursing staff to enable them to treat patients with learning disabilities more effectively.  Consultants have a level of training, but there was a need to support staff and keep training fresh and up to date with modern care, and not focus solely on mandatory training, but get refresher training in areas of expertise.




·                It was recognised that people with autism should not be classed as people with learning disabilities, and there was a need to look at how best to support someone with autism, especially in an in-patient setting to be able to address their needs. 




·                Through primary care and IACT, improvements were required to be made as it was known that males within the BAME communities for a number of reasons do not access services at primary care level and there was a need to make sure, with advocacy and the voluntary sector within those communities, that they were confident to get the help they need early on.




·                The general approach was to understand the needs, histories, backgrounds and cultures, which significantly vary amongst communities.  The Roma Slovak community was one of the most disenfranchised communities, their needs were very different to other ethnic communities and there was a need to understand that one size doesn’t fit all.




·                Translation and Interpretation Services were always made available as it was never appropriate to think that someone might be able to translate or interpret.  There was a need to build a linguistic and diverse workforce.




·                Significant numbers of staff were registered, qualified professionals. Staff were paid in accordance with the national pay grade, depending on qualifications, there was little control at a local level on staff pay.




RESOLVED: That the Committee:-




(a)      thanks Jan Ditheridge and Dr. Mike Hunter for attending the meeting;




(b)      notes the contents of the presentation and responses to questions raised; and




(c)      notes and welcomes the improvement since May 2020 to August 2021.