Locala Community Partnerships C.I.C. Also known as Kirklees Community Healthcare Services

Updated 24 February 2020

Not used

Updated 24 February 2020

Our rating of the organisation improved. We rated it as good because:

We rated safe, effective, caring, responsive and well led as good. We rated all four of the core services we inspected as good overall. In rating the organisation, we took into account the previous rating of the core service we did not inspect this time.

• We rated well- led for the organisation overall as good. The leadership, governance structure and culture within the organisation showed an open, effective and person-centred approach which was driving improvements to deliver good quality, patient centred care.
• We saw a strong vision and set of values which were shared across the organisation. Staff in core services knew the vision and values and had the opportunity to input into them.
• Locala had systems in place to identify learning from incidents, complaints and safeguarding alerts. Locala used safety summits to share information between teams and had recently enabled colleagues to access these through skype to improve attendance.
• There was an open incident reporting culture, staff knew how to report incidents and there was evidence of learning from incidents; there were comprehensive arrangements and procedures for safeguarding and feedback we received from external stakeholders in relation to safeguarding was positive. Staff in core services demonstrated a good understanding of safeguarding and knew how to protect patients from abuse.
• Robust arrangements were in place for identifying, recording and managing risks, issues and mitigating actions. Recorded risks were aligned with what staff said were on their ‘worry list’. Locala had a risk profile which identified their highest scoring risks, there were key performance indicators in place to monitor risk management and we could see that risk was discussed regularly at both board and committee meetings.
• On the whole mandatory training compliance figures were good. Staff said they had access to both internal and external learning. Locala’s coaching programme had been shortlisted for the training journal awards in the category of best coaching / mentoring programme.
• The organisation worked collaboratively with external partners to provide the highest quality of care. Locala was the lead provider for an innovative partnership which brought together five organisations and their 0-19 services to help ensure that all children, young people and families living in Kirklees will be healthy and resilient. Feedback from external stakeholders included recognition of Locala embracing new ways of working.
• Across the four core services we saw that staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.

However:

• Although Locala had an LGBT staff network they had not yet developed a Black and ethnic minority or a disability staff network. Locala had recognised that there was a need to develop further staff networks however these were not yet in place.
• In the community health services for adults, risk assessment reviews were not always documented on the electronic patient record. Staff were completing reviews of risk and these were discussed with the multidisciplinary team however documentation was not always updated in the risk document. In the children, young people and families service we saw some clinical records were not completed within the 24-hour timeframe. Records not completed within the 24-timeframe varied between 1% and 4%.
• In the community health services for adults not all mandatory training was compliant with the organisational target.
• In the children, young people and families service the 0-19 service in Kirklees had very high caseloads which were significantly above the organisations recommended colleague caseload.

Updated 24 February 2020

• The service provided mandatory training in key skills to all staff. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. The service controlled infection risk well. The design, maintenance and use of facilities, premises and equipment kept people safe. Staff identified and quickly acted upon patients at risk of deterioration. The service had enough staff with the right qualifications, skills, training and experience. The service managed patient safety incidents well. The service used monitoring results well to improve safety.
• The service provided care and treatment based on national guidance and evidence-based practice. Staff regularly checked if patients were eating and drinking enough to stay healthy and help with their recovery. Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way. Staff monitored the effectiveness of care and treatment. The service made sure staff were competent for their roles. All those responsible for delivering care worked together as a team to benefit patients.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However, we found the following issues that the service needed to improve:

• The provider did not always ensure that information in relation to medicine allergies were clearly highlighted in patients’ care records.
• Mandatory training compliance figures were low in some areas, particularly in relation to medical staff.
• Staff only assessed and mitigated risk of patients when a risk actually presented and did not record any reviews of risk within care records.

Updated 24 February 2020

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

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse. Staff controlled infection risks well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• In one of the services, staff had very high caseloads, which was affecting service provision as staff were completing some visits over the telephone rather than face to face. This was being monitored and risks were being mitigated through a system of identifying and prioritising families that were vulnerable or most in need of support.
• We saw some environmental concerns including the lack of a radiator cover within a sensory room for children and some poorly kept cleaning records
• Some of the records were not inputted onto the system within the 24 hours timescales required.

Updated 24 February 2020

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

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• The waiting times for an initial assessment were excessive. As of November 2019, there were currently 501 children on the waiting list for an assessment (including new referrals received). The service was fully aware of this and was taking action to reduce the waiting times.
• Improvements could be made to the audit process to ensure audits of dental care records are relevant to dentistry.
• An audit of antimicrobial prescribing had not been carried out.

Updated 24 February 2020

This is the first inspection of the sexual health core service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service. 
• Staff provided a holistic patient centred approach to planning and delivering care and treatment, proving high quality care. All staff were actively engaged in monitoring the effectiveness of the service to improve quality and outcomes for patients. Innovative and evidence-based techniques were used to improve the service. Staff development was a priority for the service and there was evidence of strong collaborative working.  
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers. 
• The service had the individual needs of patients central to the planning and delivery of care. Services were flexible and used innovative approaches to ensure the services met the needs of people needing them. There was active engagement with other agencies to support those most vulnerable to access services at the right time and there was a proactive approach to understanding the needs of those using the service. Work had been done and was ongoing to ensure people could access services in a timely way. 
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff had common values and felt respected, valued and supported. Staff were clear about their roles and accountabilities They were focused on the needs of patients and adopted innovative approaches to continually improve patient care. The service engaged well with other organisations within the community to plan, develop and manage services

However:

• Recording systems at times did not provide managers and staff with key management information. This included the monitoring of staff sickness and its impact on appointments and clinic times, the delayed recording of medical sessional staff mandatory training course completion and clinic cleaning log form which did not provide for full recording in line with policy.
• There were some environmental safety concerns as nurse call alarms were not within easy reach of patient examination couches in all location inspected to help nurses in the event of an emergency. At Huddersfield, the reception area did not provide patients with privacy when checking into their appointment and some paintwork was flaking with a risk to infection control.
• Staff were not aware of a service strategy or vision and some complaints were not managed in a timely manner or in accordance with the policy.