CQC publishes report on community health services for children and young people at Bradford District Care NHS Foundation Trust

The independent regulator of health and social care in England carried out an inspection in June after receiving concerns about the quality of care being provided.

Following this inspection, all the ratings remain the same. The service is rated as requires improvement overall and for being safe and responsive to people’s needs. Effective, caring and well-led are rated as good. The overall trust rating remains rated as good.

Bradford District Care NHS Foundation Trust provides a number of children’s services across Bradford and Wakefield.

'Leaders passionate about making improvements'

Brian Cranna, CQC head of hospital inspection for mental health and community health services, said: “During our inspection of community health services for children and young people at Bradford District Care NHS Foundation Trust, we found a service that was well-led, and leaders knew about the challenges they faced and were passionate about making improvements. These included taking action to recruit more staff and offering development opportunities to existing staff.

“We found staff treated children, young people and their families with compassion and kindness and were enthusiastic about the roles they performed and wanted to provide high quality care. Staff recognised the importance of mental and emotional health as well as physical health and offered appropriate support and information to families.

“However, we did find some inconsistencies with record-keeping. Some of the records we reviewed didn’t show what actions had been carried out when there was concern about risks to a child or their family. The trust was aware of this and were addressing the issues when we inspected.

“Overall, this is a well-led service, however improvements are required to improve patient care. Leaders are taking action to make the necessary changes and we will return to check on progress.”

Inspectors found:

• The service did not have enough staff, there were several unfilled vacancies and staff were holding caseloads much larger than recommended by national guidance. Staff sickness and turnover levels were high.

• Aspects of the service were in business continuity which meant that not all services were being provided. There were waiting lists in place in the looked after children’s team which meant that children waited for individual health assessments longer than they should, and this was not in line with national guidance.

• The service worked on a risk-based approach whereby children were placed into four tiers dependent on need. We were concerned that in some cases late identification of health conditions and disabilities could occur for those children in lower tiers of need due to lower levels of oversight for these families.

However:

• Staff supported people to live healthier lives and thought of different ways to engage harder to reach service users.

• The service was beginning to consider and introduce some innovation ways of working to meet the needs of the local population.

• Leaders at all levels of the service were knowledgeable and passionate and sought to drive improvement.