The Care Quality Commission highlight ‘outstanding practice’ in Devon County Council’s Public Health Nursing service, following a recent inspection.
Picked out for particular praise in their report published today (Monday 23 January) is the service’s work in partnership with schools to improve support for children with special educational needs and disabilities, (SEND).
They also commend as outstanding the service’s support to families fleeing Ukraine and Afghanistan, and for mothers regarding perinatal and infant mental health.
And they highlight the service’s promotion among its staff with information to support people experiencing menopause.
The service’s evaluation of its own response during the coronavirus pandemic across its Early Years service, is also described as outstanding.
Overall, CQC inspectors rate Devon’s Public Health Nursing service as ‘good’ across all measures – for being ‘Safe’, ‘Effective’, ‘Caring’, ‘Responsive’, and ‘Well-led’.
Inspectors found that ‘people using the service say that staff were approachable, friendly, helpful and reassuring.’
‘They were spoken to with respect and care which made the visits personal and comforting.
‘People using the service felt they could trust staff and felt they were in good hands.’
Inspectors found that most families could access the service when they needed it and received the right care in a timely way.
And that families said that ‘...the process was easy, from needing an appointment to attending it.’
People also told inspectors that it’s ‘great to have consistency with the health visitors.’
‘Staff regularly checked if children and young people were eating and drinking enough to stay healthy.
‘Staff monitored the effectiveness of care and treatment... and used the findings to make improvements.’
And, ‘Staff understand how to protect children, young people and their families from abuse, and the service worked well with other agencies to do so. The service controlled infection risk well,” inspectors report,” using equipment and control measures to protect children, young people, their families, themselves and others from infection.’
And risk assessments are used routinely for each child and young person, and are quickly acted on if an individual is at risk of deterioration.
Inspectors note that the service has 24-hour a day access to mental health liaison and specialist mental health support, and that staff are familiar with how families can access the support they need.
‘The service was inclusive and took account of children, young people and their families’ individual needs and preferences,’ they said.
They report that staff have the right qualifications, skills and training and experience to keep children and young people safe from avoidable harm.
But in their report, inspectors also note that the service did not have enough nursing and support staff to provide care and treatment to some children and young people, with vacancies particularly high in East Devon.
Recruitment difficulties mean that the service’s health visitors are managing caseloads larger than is recommended nationally.
‘Detailed records, (kept by staff about young people’s care and treatment), were clear, up-to-date, and stored securely,’ but that those records were not easily available for all staff providing care.
Inspectors noted that staff could not find the data they needed in easily accessible formats, to understand performance and to make decisions and improvements.
And that back-office information systems were secure, but not integrated.
Some families told inspectors that they thought it a shame that some of the drop in sessions were no longer running and that the service would benefit from having more face-to-face contact rather than video contact.
Councillor Andrew Leadbetter, the Council’s Cabinet Member with responsibility for the Public Health Nursing service said:
‘I am very pleased with CQC’s findings. Their inspectors found a lot that we are proud of and describe a service that is well-led, well-run, and that is providing great benefit to individuals and young families.
‘In particular, I’m pleased that inspectors note as outstanding our work with schools to support children with special educational needs and disabilities. And that they note the excellent work we are doing with new parents and babies because it’s so important to us that families get the best possible start in life.’
‘But, we know that there’s room for improvement. The recruitment of trained professional public health nurses and health visitors is historically challenging, here in Devon as it is across the country, and that poses us difficulties with higher than the national average for case loads, and ensuring timely support to people on occasion.
‘We have a strategy in place to improve our recruitment and retention, and I’m confident that we’ll see improvement in that respect over coming months.
‘We are also constantly re-evaluating the delivery of our service in this post-pandemic period. Coronavirus hasn’t gone away and there are other viruses around that we all must continue to be careful about. But we hear what some families say about face-to-face contact and have opened the service back up to have more of that direct contact, while still maintaining telephone contact for initial triage.’