Mid Cheshire Hospitals NHS Foundation Trust

Updated 14 April 2020

Mid Cheshire Hospitals NHS Foundation trust provide services to a population of approximately 300,000 living in and around Alsager, Crewe, Congleton, Knutsford, Middlewich, Nantwich, Northwich, Sandbach and Winsford. The demographics of the area shows most people are born in England and there are very small percentages of people from other nationalities.

Mid Cheshire Hospitals NHS Foundation trust provides acute care from Leighton Hospital in Crewe and Victoria Infirmary in Northwich. They also provide community services for adults and children and young people through the Central Cheshire Integrated Care Partnership and intermediate care from the Elmhurst Intermediate Care Centre in Winsford. The trust was formed in April 1991 and became a foundation trust in April 2008.

The trust has a total of 556 beds across 21 inpatient wards. There are 38 day case beds and 28 beds for children. They employ more than 4,500 members of staff and provide a range of services including urgent and emergency care, maternity, outpatients, therapies, and children's health.

The Trust is also part of Central Cheshire Integrated Care Partnership (CCICP), a local health partnership that provides a range of community health services for people across South Cheshire and Vale Royal.

Updated 14 April 2020

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

We rated safe as requires improvement.

We rated effective, caring, responsive and well led as good at acute and community service level.

We rated well led for the trust as good.

The use of resources was rated as good.

This gave a combined quality and resource rating of good.

Updated 14 April 2020

Updated 14 April 2020

Updated 19 September 2018

• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
• There were good examples across all services where integrated care was provided.
• The trust used a capacity and demand tool to monitor caseloads and manage staffing across the community teams. Managers assessed and prioritised their caseloads daily and where teams were understaffed, staff were reallocated to meet demand.
• Patients were supported to live healthier lives and good health promotion activities were demonstrated across the communities.
• Staff cared for patients with compassion and respect.
• All patients we spoke with confirmed that staff treated them well and with kindness.
• Staff involved patients and those close to them in decisions about their care and treatment.
• The trust planned and provided services in a way that met the needs of local people.
• The trust monitored the changing needs of the community and used feedback from patients and stakeholders to monitor their services.
• The service took account of patients’ individual needs.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.
• The trust had managers at all levels with the right skills and abilities to run a service providing high-quality sustainable care.
• The trust had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community.
• There was a clear strategy which was embedded throughout the services we visited and staff were all aware of the plans for transformation of the community services.
• Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The trust was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation.

However:

• The service needed to make improvements to ensure services were safe. Not all staff had completed mandatory training, including safeguarding training. Equipment was not always maintained appropriately and medicines were not administered and stored well. Staff recognised incidents but did not always report them. Records were not up-to-date or easy to follow and could not be accessed by all staff.
• Not all staff received clinical supervision and staff found it difficult to access appropriate training to maintain their competencies.
• The service did not always investigate and respond to complaints in a timely manner in line with trust policy.

Updated 14 April 2020

Our rating of this service improved. We rated it as good because:

• The service provided mandatory training in key skills to all staff. 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, regularly checked if children and young people were eating and drinking enough 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 children, young people and their families, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated children and young people 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 children and young people, their families and carers.
• The service planned care to meet the needs of local people, took account of children, young people and families’ 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 children and young people receiving care. Staff were clear about their roles and accountabilities. The service engaged well with children, young people, their families and the community to plan and manage services and all staff were committed to improving services continually.

However

• The service did not always make sure all staff completed mandatory training. There were not always enough occupational therapy staff to provide the right care and treatment for children and young people. Some medicines charts had incomplete photographic identification records, and access to electronic records in some community locations was more limited. Key services were not available seven days a week and waiting times for some community services in paediatric occupational therapy and speech therapy did not meet targets.