• Dorset Healthcare University Foundation Trust rated “outstanding” by CQC
  • Trust was rated “requires improvement” in 2015
  • Leadership development and quality improvement key to rating, says chief executive 

Reverse mentoring and a “retreat” for self-referring patients who feel in crisis are just two of the factors which earned a mental health and community trust an “outstanding” rating.

That’s according to Eugine Yafele, chief executive of Dorset Healthcare University FT, which won praise from the Care Quality Commission for its “outstanding” leadership and caring staff.

The CQC rating marks a four-year high since the trust was told it “requires improvement” in 2015.

Mr Yafele said he felt “absolute delight” when he read the report. 

Asked how the trust had achieved the “outstanding” rating, Mr Yafele, a former mental health nurse, told HSJ the two most important factors were “leadership development and quality improvement”.

Beyond the “usual suspects”

On leadership, he said the trust had made significant changes to its leadership teams across all levels and provided the leaders with help and support much more than previously.

One example of this support included reverse mentoring, where senior directors are paired with lower-grade staff to share knowledge and learn about the organisation from a different perspective.

Mr Yafele, whose mentor is a band four domestic supervisor with whom he meets every six weeks, said leaders normally go to the “usual suspects”, such as inpatient and outpatient areas, when they want to talk to people in the organisation.

He said: “For me, there’s a perspective from our support cleaning and catering staff which interfaces with patients on a daily basis which is underutilised in terms of gathering intelligence and drawing on the experience of what it’s like to be in our organisations.

“You get that sense-check of what it’s like to be in the organisation and to be on the receiving end of the decision that ultimately I’m responsible for.

“It was part of drawing people in and becoming a more inclusive and responsible organisation because there’s a risk we applaud ourselves on hearing just a few voices yet our services touch a lot of people, and, by bringing in the perspectives of those people, that helps out to really improve how we do things.”

An “alternative to hospital”

Mr Yafele, the trust’s former deputy chief executive who replaced long-serving chief executive Ron Shields in early 2019, said the leadership development had a direct link to quality improvement.

Asked for examples of specific initiatives which had raised the quality of care for patients, Mr Yafele highlighted a “retreat” for mental health patients, which was established in Bournemouth last year.

The facility can help both seriously ill patients and people with minor problems.

“This is an alternative to hospital where patients present in crisis, and this is a crisis that they define,” Mr Yafele said.

“We might end up suggesting that the patient needs a hospital bed, but – if you look at it from the patient’s perspective – their experience in a place they find welcoming and staffed by people who understand what they’re going through is much better than being detained under section 136 or going to an emergency department.”

He said the acute providers in the area had noticed a reduction in the number of mental health patients attending their emergency departments.

Gold standard

Another example was the trust becoming the first in the country to obtain a “gold standard framework” for its older people’s mental health wards in its community hospitals.

This accolade is mainly given to palliative care providers, but the trust’s success in achieving the grade was praised by the CQC.

Inspectors said in their report: “The GSF is a systematic evidence-based approach to ensuring all patients approaching end of life receive the best possible compassionate care in the best possible place.

“This meant patients approaching the end of their lives on these wards could remain on the ward rather than be transferred to another place to receive this care.”

Commenting on the inspectors’ findings, Paul Lelliott, the CQC’s lead for mental health and deputy chief inspector of hospitals, said: “I am delighted at this achievement which is a credit to all of the trust’s staff.

“Their hard work is making a real difference to the lives of people using the services.”

The trust is part of Dorset’s integrated care system.