Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

Following a comprehensive inspection the Care Quality Commission (CQC) has rated services at the Trust as ‘Good’ overall in its report published on 27 July 2016.

The Trust was rated ‘Outstanding’ in the ‘Caring’ domain, overall and separately for hospital-based and community services. It was rated ‘Good’ overall in the ‘Effective’, ‘Responsive’ and ‘Well-led’ domains.

The ‘Caring’ domain is scored by how well staff involve and treat people with compassion, kindness, dignity and respect. The CQC noted that “across the Trust we found staff kind, caring and taking extra steps to improve their patients’ experience of the services”.

Several of the Trust’s services were rated ‘Outstanding’. At Harrogate District Hospital, both Critical Care and Outpatients and Diagnostic Imaging services scored this highest possible grade. The Trust’s Community Adult service and Community Dental service were also rated ‘Outstanding’.

Particular areas of outstanding practice identified by the CQC include:

  • Clinical psychology service to inpatients and outpatients at the follow-up clinic in Critical Care. The use of patient diaries on Critical Care by the Multidisciplinary Team was also praised.
  • The Critical Care Outreach team’s leadership, advanced clinical skills and commitment to education.
  • Diabetes Specialist Nurses who use medicines system information to monitor patients’ blood sugar readings and insulin doses.
  • The redesign of the acute admissions and assessment pathway, known as the ‘FLIP’ project was outstanding. The project was initiated and driven by staff.
  • The supporting intensive therapy unit patients (situp) service.
  • The Community Dental Service offering individual care that was specific to the patient’s needs. Where conventional care would not meet the needs of the patient, the service was willing to adapt to meet their needs.
  • The Community Dental Service responded effectively to the needs of the community and staff were actively seeking out groups of people who were at risk from poor dental hygiene or who were normally excluded from routine dental treatment.
  • Community health services for adults were outstanding overall and specifically in relation to caring and being well-led. Feedback from patients was consistently positive and they told the CQC that staff go the extra mile which was witnessed during the inspection.

The CQC found the Trust ‘Requires Improvement’ in the ‘Safe’ domain. Many of the issues picked up by the CQC have already been addressed and an action plan is in place to address the remaining points raised.

CQC Insight for Acute NHS trusts

During 2017, the CQC has started to publish a tool called Insight, used to monitor the quality of care in acute and specialist NHS trusts, mental health services, GP practices and adult social care services.

There are more than 300 indicators used to monitor acute NHS trusts. The Insight tool for each acute NHS trust is published monthly and:

  • incorporates data indicators that align to key lines of enquiry for that sector
  • brings together information from people who use services, knowledge from inspections and data from partners
  • indicates where the risk to the quality of care provided is greatest
  • monitors change over time for each of the measures
  • points to services where the quality may be improving

The Trust will be using the Insight dashboard alongside other performance information to ensure a focus on quality improvement in Trust-wide and core services. Please contact us if you would like to see our latest Insight tool.

Previous inspections

Harrogate District Hospital was inspected by the CQC in November 2013 as part of the pilot group of low risk NHS trusts. No formal rating was issued to trusts in this group.

The inspection report found that Harrogate District Hospital provided care that was safe, effective, caring, responsive and well-led. The Hospital was clean and it had systems in place for infection prevention and control. There were some areas of good practice. These included the way in which the Trust valued and used volunteers and the use of telemedicine in patient care.

The CQC also identified areas where some improvements were suggested, including staffing levels on wards caring for older people, pain control on surgical wards, the full recording of decisions around Do Not Resuscitate notices and the threshold for reporting serious incidents. The Trust took measures to improve performance in all of these areas. The CQC did not find any areas where it felt it necessary to issue a notice instructing the Trust to make improvements.