The inspection visits took place over two days and focused on services for children and people with learning disabilities within the London Borough of Hounslow and on older people services within the London Borough of Richmond. The inspection team visited a range of clinics, health centres and different services. These included the children’s therapy department, a health visitor’s clinic, the children’s healthy weight team and the community team for learning disabilities in the Borough of Hounslow. We also met staff from Hounslow services including a school nurse, therapists and safeguarding leads. In the London Borough of Richmond we visited a falls clinic, a pressure ulcer clinic, met therapists, a dietician, tissue viability nurses and community matrons. We met staff involved in clinical governance and quality monitoring. We attended part of the Trust’s pressure ulcer task force meeting.

We met people who use the service and their representatives throughout our visit. We also spoke with people over the telephone and contacted key stakeholder organisations including LINk (Local Involvement network), the fire service, local authority staff, care home providers and advocacy services.

People told us that the Trust offered a good service which met the needs of the community. They said that they worked with other agencies and members of the community to identify community and individual needs. They told us that services were person centred and focussed on individual wishes and wellbeing. People who used the service said that they were well informed about their care and treatment and that they were able to make choices about this. They said that the staff were skilled and competent. They told us that they were treated with respect and kindness.

Other professionals told us that the Trust worked closely with them. One professional said, ‘’Trust staff are truly fantastic and willing to help us in any way’’. Richmond upon Thames LINk told us said that they had received positive feedback from people who use the Trust’s services. Other organisations said that they worked in close partnership with the Trust developing services for the community.

We found that people who use the services we inspected were treated with respect. They were involved in decisions about their own care. They had individualised care packages which met their needs. People were supported to feel safe and the Trust worked with other agencies to keep them safe. The clinics we visited were clean and well maintained and staff followed appropriate infection control procedures. The staff told us that they felt well supported and trained and we found them to be competent and skilled. The staffing levels in some departments meant that not everyone who needed the service could be supported. The Trust has robust systems for monitoring quality and planning improvements.