The Care Quality Commission (CQC) has downgraded the rating for
how well-led Cambridgeshire and Peterborough NHS Foundation Trust
is overall from good to requires improvement following an
inspection in February this year.
The trust provides a wide range of mental health, physical
health, specialist, learning disability and neuro-rehabilitation
community and hospital services to a population of around 950,000
people across the East of England. Services operate from over 50
sites, with main hubs in Cambridge, Huntingdon, Peterborough and
Fenland.
This inspection was carried out in response to concerns about the
trust's culture and leadership identified during previous
inspections of three of its mental health services.
The inspection focused solely on how well-led the trust is. CQC
now gives NHS trusts a single trust-level rating focusing on
leadership and culture that replaces all other ratings at a trust
level. This simpler, more focused approach to rating NHS trusts
reflects the strong correlation CQC has found between the quality
of leadership at an organisation and the quality of care being
delivered. CQC continues to inspect and rate individual hospital
services and locations to capture how people are directly
experiencing care at that level.
Stuart Dunn, CQC deputy director of operations in the
East of England, said:
“During our inspection, we saw a workforce and board committed to
working more collaboratively, from a place of mutual respect
under new leadership. While the trust had begun to take steps to
improve culture and inclusion, leadership arrangements weren't
fully embedded or consistently effective which is important to
deliver meaningful impact for staff and people using services.
“Many staff told us they still didn't feel confident raising
concerns, and there were reports of poor communication and a lack
of visible leadership. These are important areas for the trust to
address to ensure staff feel safe, valued and heard as staff
raising concerns plays an important role in improving people's
experiences.
“We also found that although the trust had outlined strategic
priorities, leaders didn't always clearly understand them or turn
them into meaningful action. As a result, frontline teams often
lacked the clarity or support needed to improve care.
“However, we have seen encouraging signs of progress. The new
chief executive was well received by staff and stakeholders, who
described him as open and approachable. He had taken swift action
where needed and under the chair's leadership had the board and
executive team working together in a respectful and collaborative
way, creating a stronger foundation for the improvements that CQC
needs to see happen.
“We saw committed staff who were enthusiastic and focused on
supporting people. We saw good examples of innovative practice,
inclusion and integrated care, such as services helping people
manage their medicines safely and independently at home.
“We've shared our findings with the trust, so they know where
improvements are needed, and we'll continue to monitor them
closely, including through future inspections, to ensure people
are safe whilst this happens.”
Inspectors also found:
- The trust didn't always respond to complaints within agreed
timescales, and learning from them wasn't consistently recorded
or shared.
- The trust was developing co-production to involve people
using its services and their carers to help design services, but
it wasn't yet embedded across the organisation.
- Staff continued to raise concerns about discrimination, with
limited evidence that current equality, diversity and inclusion
plans had improved staff experience.
However:
- The trust was delivering positive examples of integrated
physical and mental health care, including innovative services
and partnerships such as the Cambridge Children's Hospital
project.
The report will be published on CQC's website in the
next few days.
