From April 2010, all health and adult social care providers who regulated activities are required by law to be registered with the Care Quality Commission.
CQC is the independent regulator of health and adult social care in England. CQC register care providers, monitor, inspect and rate the services to make sure care services provide people with safe, effective, compassionate, high-quality care and encourage improvements within services. If the CQC find that care has fallen short they can use their power to actions against those responsible.
The way they regulate care services involves:
- Registering people that apply to them to provide services.
- Using data, evidence and information.
- Using feedback from the public
- Inspections carried out by experts
- Publishing information and ratings following on from inspections
- Taking action when services need to improve or to make sure those responsible for poor care are held accountable for it.
Following a comprehensive inspection by the Care Quality Commission (CQC), the Trust has maintained its ‘Good’ rating – with all core services now rated ‘Good’ or ‘Outstanding and Community Services as a whole now ‘Outstanding’.
The Trust also maintained its ‘Outstanding’ rating for providing ‘Caring’ services overall. The ‘Caring’ domain is scored by how well staff involve and treat people with compassion, kindness, dignity and respect.
All services inspected increased their rating when compared to the previous report in 2016. Surgery and Community Services are now both ‘Outstanding’ overall. Services for Children and Young People, Community Health Inpatient Services (Trinity Ward at Ripon Community Hospital) and Urgent care (Minor Injury Units in Ripon and Selby) are now each ‘Good’ overall.
The newly ‘Outstanding’ services join Critical Care, Outpatients and Diagnostics, Community Health Services for Adults and Community Dental Services, who maintain their ‘Outstanding’ rating. Each of the other Trust services have maintained their ‘Good’ rating.
Specific areas of outstanding practice identified by the CQC in its report include:
- “There is a fully-embedded and systematic approach to improvement across the Trust, and a strong focus on quality improvement which is well embedded.”
- “In Surgery, all patients the CQC inspectors spoke with gave excellent feedback about the care they received from all levels of staff, including consultants, domestics and porters. Staff are highly motivated and extremely proud of the level of care they deliver, with senior managers enabling staff engagement through collaborative working and networking.”
- “In Services for Children and Young People, staff are caring, compassionate and respectful, and listen to feedback from parents, children and young people to make improvements. Services are planned and provided in a way that meets the needs of local people.”
- “In Community Health Inpatient Services (Trinity Ward at Ripon Community Hospital), the CQC found that the team has made improvements in the focus on patient rehabilitation, holistic care and therapy planning. Staff were seen to be compassionate and caring in their approach. Patients’ nutritional needs are well-managed.”
- “Urgent care (Minor Injury Units in Ripon and Selby) has been found to be of a consistently high standard and safe, provided in environments that are suitable and well-maintained. Staff are highly qualified, experienced and efficient, providing care in a compassionate and respectful way.”
Previous inspections
The Trust was previously inspected in 2016 – where the Care Quality Commission rated our services as ‘Good’ overall in its report.
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”.
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.
Before that, the Trust 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.