County Offices, Newland, Lincoln provided health visiting and children and young people nursing services to children, young people and families in the county of Lincolnshire.

We found the following areas of good practice:

Staff recognised safety incidents and reported them appropriately. They were investigated and staff learned from them. Staff knew how to keep children safe and were trained to recognise and report abuse appropriately. Children’s records were kept securely, and individual risk assessments were clearly documented. Contingency plans for the interruption of services were in place.

Services were based on national guidance with managers monitoring the delivery of the Healthy Child Programme and ensuring staff were competent to undertake their role. Staff from different agencies worked well together to benefit children and families: with staff referring and transferring children to other services safely. Staff understood how and when to obtain consent before sharing information with other agencies.

Staff cared for children and families with compassion, providing emotional support when necessary. They involved parents in decisions about their children.

The service planned and provided services in ways that met the needs of local people and their communities, using innovative ways to improve service provision. The service took account of children’s individual needs and supported those in vulnerable circumstances.

The service had a vision for the future of service provision involving staff and parents. Managers had the skills and abilities to run the service, providing high quality sustainable care. It collected, analysed, managed and used information to support all its activities ensuring high standards of care. The staff were committed to improving the service and using innovation.

However, we also found the following issues that the service provider needs to improve:

Infection prevention and control measures were insufficient to protect children from harm. Staff did not adhere to good hand hygiene and the cleaning of toys was inconsistent. In some areas there was insufficient space to ensure privacy and confidentiality and at times staff had to carry equipment between clinics in order to undertake their work.

Lone working safety measures were inconsistent across the service and the service had insufficient staff to ensure children were safe and to provide the right care. However it was acknowledged a continuous programme of recruitment for health visitors was in place.

Performance figures for four of the five mandated health visitor contacts had not reached the service’s own target of 95%.

Morale amongst health visitors was low in a number of areas across the county and they felt undervalued. Some staff feared retribution if they spoke out. The service risk register did not reflect the risks we identified during our inspection and the provider had no feedback mechanism for its health service provision.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice. Details are at the end of the report.