Sussex Community NHS Foundation Trust

Updated 30 July 2018

Sussex Community NHS Foundation Trust provides NHS community health and care services across West Sussex, Brighton and Hove and High Lewes Havens area of East Sussex. The trust works with five clinical commissioning groups in the delivery of care; coastal West Sussex, Mid Sussex and Horsham, Crawley, Brighton and Hove, and High Weald Lewes Havens. They provide a wide range of medical, nursing and therapeutic care. They work to help people plan, manage and adapt to changes in their health, to prevent avoidable admission to hospital and to minimise hospital stay.

The trust provides a range of clinical services via inpatient and outpatient locations to a population of more than 1.3 million people.

This trust has 14 registered locations:

• Arundel and District Hospital
• Bognor Regis War Memorial Hospital
• Brighton General Hospital
• Chailey Clinical Services
• Crawley Hospital
• Crowborough War Memorial Hospital
• Horsham Hospital
• Lewes Victoria Hospital
• Midhurst Community Hospital
• Newhaven Rehabilitation Centre
• Salvington Lodge
• The Kleinwort Centre
• Uckfield Community Hospital
• Zachary Merton Community Hospital

From June 2016 to July 2017 the trust provided the following services:

• Community inpatient services
• Community health services for adults
• Community health services for children, young people and their families
• End of life care
• Community dental health services
• Sexual health services
• Urgent care centre (additional service)

Updated 30 July 2018

Our rating of the trust stayed the same. We rated it as good because:

• Safe, effective, caring, responsive and well led were good.
• Community inpatients was good overall. Safe had improved from requires improvement to good. Caring had improved from good to outstanding.
• Community dental services were good for safe, effective, caring, responsive and well led. This was the first time this service had been inspected.
• Sexual health services were good for safe, effective, caring, responsive and well led. This was the first time this service had been inspected.
• In rating the trust, we took into account the current ratings of the three services not inspected this time.

Updated 30 July 2018

• Staff reported incidents appropriately. Incidents were investigated, shared, and there was evidence of lessons learned.
• Staff understood their safeguarding responsibilities and could describe the safeguarding policies and procedures. Staff had up to date safeguarding training at the appropriate level.
• Medicines were stored, handled and administered safely.
• Equipment was well maintained and fit for purpose.
• Staffing levels were appropriate and met patients’ needs at the time of inspection.
• Patients’ individual care records were comprehensively written in a way that kept people safe. Relevant information was recorded appropriately and staff had access to relevant details before providing care.
• Standards of cleanliness and hygiene were generally well maintained. Systems effective in preventing and protecting to prevent and protect people from a healthcare associated infection.
• Mandatory training was provided for staff and compliance met or exceeded the trust targets in most topics.
• Staff had the necessary qualifications and skills they needed to carry out their roles effectively. Further training and development opportunities were available for staff.
• Appropriate systems were used to respond to medical emergencies.
• Patients’ needs were assessed and their care and treatment was delivered following local and national guidance for best practice.
• The service followed effective evidence based care and treatment policies which were based on national guidance.
• There was evidence of good multidisciplinary working with staff. Teams and services worked together to deliver effective care and treatment.
• During the inspection, we saw and were told by patients, that all staff working in the service were kind, caring and compassionate at every stage of their treatment.
• People were treated respectfully and their privacy was maintained in person and through the actions of staff to maintain confidentiality and dignity.
• Staff were sensitive to the needs of all patients and were skilled in supporting patients and young people with disabilities and complex needs. We saw there were systems to ensure that services were able to meet the individual needs, for example, for people living with dementia and learning disabilities.
• Staff involved patients and those close to them in aspects of their care and treatment. Information about treatment plans was provided to meet the needs of patients.
• There was an effective system to record concerns and complaints about the service. Complaints were reviewed and actioned appropriately with a view to improving patient care.
• Staff told us that they felt supported by their immediate line managers and that the senior management team were visible within the department.
• There was a very positive and forward looking attitude and culture apparent among the staff we spoke with.

However:

• Staff raised concerns with us regarding the information technology (IT) system used to record patient information and notes in all locations of the community dental services. The clinical records did not always provided a consistent, reliable and effective system for the recording and retention of patient information
• The Lancing Health Centre and Chailey Heritage Clinical Services did not have dedicated decontamination rooms. Staff told us there was no definitive action plan, including a date when this would be addressed.

Updated 30 July 2018

• There were systems and processes in place to keep patients safe from harm.
• Safety had improved overall and managers closely monitored staffing issues and addressed them as required. Medicines management and audit had improved.
• Records were being simplified, so all patient information was held in one location.
• Staff were competent to deliver care in line with best practice and demonstrated with regular audit.
• Staff delivered outstanding care to patients. We saw numerous examples where staff had gone the extra mile. Staff consistently demonstrated patients were at the centre of everything they did.
• Services were delivered in line with the needs of the local population. Patients individual needs were considered and catered for.
• The service was well led by dedicated managers who were driven to provide the best quality service. The culture of the service in all areas we visited was one of teamwork to deliver high quality care. Staff clearly demonstrate the trust’s values.

However:

• We identified problems at Crawley hospital with regard to referral to mental health services and monitoring and administrating pain relief.
• Advice on how to complain was not consistently displayed throughout all locations we visited.