THE quality of services provided by a Somerset NHS Foundation Trust have been found to ‘require improvement’.

Yeovil District Hospital NHS Foundation Trust received the rating following an inspection from the Care Quality Commission (CQC) in December 2018 and January 2019.

While the overall quality rating remains unchanged from the previous inspection, the trust is now rated ‘good’ for being caring, effective and responsive and is rated ‘requires improvement’ for being safe and well-led.

A team of inspectors checked the quality of five services - urgent and emergency services, medical care, maternity, services for children and young people, and end of life care.

Yeovil District Hospital, the trust’s main centre, was rated as ‘good’ for being effective, caring, responsive and well-led. The hospital was rated 'requires improvement' for being safe. Overall, the hospital is now rated as 'good', a step up from its previous rating of 'requires improvement'.

The CQC has also published the trust’s use of resources report, which has been rated as ‘inadequate’.

Dr Nigel Acheson, CQC’s deputy chief inspector of hospitals, said: “Yeovil District Hospital NHS Foundation Trust has worked incredibly hard to embed the improvements we requested from our previous inspections and I want to congratulate the trust for the work done and for its consistent work with other organisations to improve the services offered to the local community.

“Staff have worked hard to transform the emergency department and it is now rated good with an outstanding rating for responsiveness. The department not only achieves national standards for treatment and response times but is in some areas exceeding these standards and this too should be congratulated.

“I am encouraged by the progress that has been made but there remains plenty of scope for further improvement, particularly in relation to ensuring sufficient oversight of risk which is an area the trust must address.

“Nevertheless, our inspectors found an exceptionally strong patient-centred culture with staff putting patients first to keep them safe and involving them in decisions which affected their treatment and care.

“We will continue to monitor the trust’s performance and will return to hopefully report on further improvements in due course.”

Within the emergency department, the needs of local people were central to the planning and delivery of services. The department had reviewed and made changes in response to patient needs and demands. Patients were streamed and assessed to ensure they were transferred to the most suitable area and to help reduce unnecessary hospital admissions.

Inspectors found improvements in medical care. The leadership had developed a culture that supported the delivery of high-quality care. There were clear processes from ward level up to the trust board. The trust worked well with the local authority and other providers to deliver high quality services. However, there was insufficient detail in the medical records of some patients around assessment of mental capacity and when a patient showed signs of deterioration.

Children, young people and their families and carers were treated by staff with compassion, kindness, dignity and respect. There was a happy atmosphere on the ward and children and young people were engaged in activities. Staff offered emotional support and reassurance to children, young people and their relatives and carers to minimise their distress. There were still issues within the children’s ward which impacted on the safety of children and young people. These had not been fully addressed, although the senior leaders had submitted a business plan which would reconfigure the layout the ward and lessen many of the risks. This was yet to be approved.

In maternity, inspectors found numerous examples where staff had ‘gone the extra mile’ and exceeded the expectations of women and their partners. Women told inspectors they viewed their midwives as friends and advocates. Staff were proud of the relationships they formed with women and their families.

People received individualised end of life care by staff in the ward areas where the patients were admitted. The specialist palliative care team reviewed all patients as soon as possible when they received patient referrals. The trust planned and provided services in a way that met the needs of local people. This included a strategy to improve recognition of people in their last year of life to enable people to be involved in decisions about their care. As with medical care, we had concerns about some of the patient’s records, and also with the management of syringe drivers for pain relief.

The full report can be found at