Trust rated ‘outstanding’ three times in a row

East London Foundation Trust was praised for its “overwhelmingly positive culture supported by patients to achieve good outcomes” in a report published today.

Following an inspection last September and October, it was rated as “good” in the effective, safe and responsive domains respectively, as well as “outstanding” for being caring and well-led.

The trust was previously achieved the CQC’s highest score in September 2016 and June 2018.

ELFT chief executive Paul Calaminus, appointed in March 2021, told HSJ the challenges ELFT have faced are similar to what other mental health and communities providers have encountered, but spoke about the work the trust had undertaken to “try and stay connected” with its local communities.

He said: “We’ve been able to build links and create ways to get funding through the voluntary sector, for small grants for people, to really help local groups when people are thinking about supporting each other.

“We’ve really tried to design, with people, how to deliver services. If, for example, some of our therapy services have been more online, what if you can’t get online?

“We’ve had these digital pods that we can set up which people can use to get online because they haven’t got the broadband.

“Overall, the most important thing has been keeping the idea of improvement, keeping the idea of how we get services to where people are, trying to keep improving and building those connections with local communities and then helping people respond to that.”

CQC inspectors carried out visits of the trust’s forensic inpatient or secure wards and its wards for older people with mental health problems.

The report’s findings said:

• The trust had “adapted, learnt and continued to make positive progress” despite challenges brought on by the pandemic;
• “Significant changes” in the trust’s executive and non-executive leadership had “gone well and provided an opportunity to improve the diversity of the board and introduce people with the breadth of experience needed to support the strategic direction of the trust”;
• There was an “overwhelmingly positive culture across the trust” and inspectors found “many examples of how they put people who use services at the centre in their work”;
• Inspectors heard of “many examples where co-production was taking place”; and
• Inspectors were “inspired” by the work the trust had undertaken on race and privilege, with work towards the development of an “anti-racism framework”.

Among areas for improvement, the CQC said there were recurring themes linked to serious incidents, with the trust’s own investigation having identified this and established some areas for improvement.

It highlighted some of the trust’s existing estate requiring work to ensure they provided a “therapeutic environment” and frustrations raised by several staff members about their experience of the trust’s IT systems.

ELFT appointed Philippa Graves as its chief digital officer in July 2020 and Mr Calaminus told HSJ she had helped the board design a “whole digital strategy” for the trust.

He said: “We have a whole work plan, in terms of how we’re going to really modernise our digital infrastructure and really enable that to support people in working.

“It’ll be a very similar approach in terms of estates because there is certainly work we need to do in terms of modernising our estate.”

He added among the first priorities will be opening a new inpatient unit in Bedford, where it has run services since 2015.

Jane Ray, CQC’s head of inspection for mental health and community health services, said ELFT had “maintained high standards of quality and safety for people using its services”.

She added: “A key factor behind this was the trust’s commitment to continually assessing its work and looking for areas where improvements could be made.

“This led to it better using data to forecast demand and capacity to improve patient flow, which was helping its services be more accessible and responsible to people’s needs…

“Achieving and maintaining an outstanding rating is the result of considerable hard work, so I congratulate all the trust’s staff for their success.”