Four further Care Quality Commission (CQC) inspection reports have been published, this time covering Acute and Community Services, the Manx Emergency Doctor Service (MEDS) and Integrated Mental Health Services provided by Manx Care, alongside the Leadership and Governance ‘Well-led report’.
The CQC was commissioned by the Department of Health and Social Care (DHSC) to review the first three services outlined above using its standard criteria – assessing whether the service is safe, effective, responsive, caring and well-led. It was noted that all services are 'caring', with some areas meeting all five standards.
It’s important to provide the context that Manx Care’s services were reviewed against standards set by the CQC, shaped by policy and legislation in the UK, which may differ from local policy and legislation in place on the Island.
The ‘Well-led’ report is a review of Manx Care’s leadership and governance arrangements at Board and executive level, as well as Manx Care’s overall organisational vision and strategy. This report acknowledged the professional experience of Manx Care’s leadership team, stating:
‘Leaders had the experience, capacity, capability and integrity to ensure that the objectives of Manx Care could be delivered and risks to performance addressed. Manx Care had a Board of experienced Directors with governance processes in place to monitor safety, quality and performance.’
A number of areas of notable practice were identified during the inspections, including the safe delivery of care and treatment being supported by multidisciplinary decision-making, relationships with tertiary centres and the innovative use of telemedicine. The Integrated Diagnostics and Cancer Service was praised for the development of its skin service to better serve this patient group, and across all areas, colleagues treated patients and service users with kindness, respect and compassion.
A particular area of note was the development of Manx Care’s Frailty Service, which had already provided positive outcomes for patients. Operating a dedicated Frailty Unit within Noble’s Hospital delivers significantly reduced lengths of stay, fewer re-admissions and lower mortality rates for patients. The launch of this service has also creates efficiencies worth in excess of £1.5m per annum, with minimal investment required to achieve this.
Some areas highlighted in the reports require targeted work to improve, and some of this work has already begun. Manx Care has reported on these in its Quality Strategy, and will continue to work alongside the Department of Health and Social Care (DHSC) to promote a culture of continuous improvement, particularly addressing areas such as medicines management processes, safe and adequate staffing, provision of safeguarding training and integration of records management systems.
Whilst the CQC’s majority focus is on quality and safety in its reports, organisational culture is equally important. The Manx Care Board has made a commitment in 2023/24 to deliver the recommendations outlined in the CQC reports, alongside work to continue to build on the development of its organisational culture, and has allocated resource to respond to this appropriately. CQC improvements are a core part of the Board’s wider commitment to quality improvement across Manx Care.
Teresa Cope, Manx Care’s CEO, said:
‘CQC inspections are an excellent opportunity to identify good practice and recognise the dedication of our colleagues in providing great care, as well as identifying areas for improvement. We have worked hard to develop our Quality Strategy as a response to the reports, setting out a number of focus areas for development and improvement, but would also like to acknowledge the aspects of notable practice that were highlighted over the course of these inspections. A number of services demonstrated fantastic, person-centred care, as well as team working, leadership and innovation. I’m incredibly proud of this.
‘I’d like to thank all of our services and colleagues who engaged in this process, and look forward to continuing to drive quality, safety and cultural change as part of our broader transformation programme on the Island.'