Serious concerns have been raised following an inspection at the Countess of Chester’s Hospital. A report by the Care Quality Commission found that the hospital’s maternity services, which are used by many North Wales residents living near the border, are “inadequate” and that other base also need to be improved.
The CQC conducted an unannounced inspection in response to concerns raised about some of its core services, CheshireLive Reports. The trust’s management was also found to be ‘inadequate’ during the inspection, after concerns were raised about the quality of care provided in four main areas, namely maternity, emergency and medical services. emergency, surgery and medical care.
The inspection took place between February 15 and March 17 this year, with the CQC saying it found that standards of patient care continued to fall below what people have come to expect, such as this was the case during the previous inspection carried out in 2018. They found that the quality of maternity services and the effective management of the trust had deteriorated and as a result two warning notices were served, requiring it to bring urgent improvements in these areas.
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In maternity wards, the lack of adequate staff and equipment has been reported as a source of concern for the safety of women and babies. The trust, which runs the 600-bed Countess of Chester Hospital and the 64-bed Ellesmere Port Hospital, was given an overall rating of ‘needs improvement’, just as it was following the previous inspection . It remains rated “needs improvement” for being safe, efficient, and responsive, and is rated good for being benevolent.
In terms of individual service ratings, maternity services ranged from good to inadequate. Medical care, surgery and emergency and emergency services remain classified as “in need of improvement”. Nor had staff learned from previous security incidents to prevent them from happening again. Security was also mentioned, with the CQC stating that all clinical areas, including the central work room, must be secured to prevent anyone from leaving the area unattended.
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In terms of emergency care, the trust needed to review the layout of the waiting room in order to minimize the length of stay of patients without access to a bed. Lack of staff training in the other essential service areas inspected was also reported as a problem, as well as poor management of patient records.
The trust, which employs more than 5,100 people, was praised by the CQC for its caring and caring interactions between staff and patients in these basic services, but work needed to be done to address concerns. The CQC said it would monitor the situation and take further action if necessary to hold the trust to account.
Karen Knapton, head of hospital inspection at the CQC, said: “While we saw caring and caring interactions between staff and patients in the wards we inspected, the trust has work to do to ensure that people consistently receive the safe and effective care to which they are entitled. expect.
“This was particularly evident in its maternity ward, which we found to be inadequate due to issues such as a lack of adequate staff and equipment to keep women and babies safe. The trust has not learned from security incidents to prevent their recurrence and, although some reviews have taken place, they have not been effective in ensuring safe care and treatment in this service.
“Medical care, surgery and emergency care had enough staff, but some lacked training for their roles, and poor management of patient records increased the risk of people being injured. We recognize that NHS services are under enormous pressure. However, senior leaders need to be visible and have good oversight to manage and mitigate challenges and risks – and we found this trust lacking.
“Despite possessing the necessary skills and capabilities, leaders failed to capture key information regarding the quality of patient care and emerging risks within the trust. This hampered their ability to develop and implement solutions, as well as target resources where they were needed.
“Since the inspection, the trust has started to address the issues we raised. It is also receiving further support from NHS England and NHS Improvement to make improvements. We will continue to monitor the trust closely and will inspect it. If improvements are not made, or if patients are at immediate risk of harm, we will take additional steps to hold trust leaders to account and keep people safe.
The inspection, which involved speaking to 142 staff and 41 patients across the trust, also revealed:
• The Trust did not have appropriate governance systems and processes in place to effectively manage patient referrals to treatment wait time performance.
• Staff have not always been able to assess patient risk due to the implementation of the new electronic patient record system. Care records were not always up to date or easily accessible.
• Security incidents were not always well managed. Actions and learning from incidents have not always taken place.
• Not all staff felt respected, supported and valued.
• The trust has not always worked well with staff, patients and the community to effectively plan and manage services.
The inspection however highlighted a number of positives, including that staff understood how to protect patients from abuse and treated patients with compassion and kindness.
The CQC ordered the trust to make several improvements to comply with the caveats and meet its legal obligations, including:
• Ensure it has effective systems and processes in place to manage referral times, to identify and respond to patient safety risks, and to capture and integrate learning as a result of patient safety incidents.
• Implement quality improvement systems and processes, including regular assessments of the quality and safety of its services.
• Ensure that patient assessments are conducted efficiently and safely.
• Train staff appropriately in the use of the electronic patient record system and ensure that only those with the necessary authorizations are able to use its prescribing functions.
Dr Susan Gilby, chief executive of the Countess of Chester Hospital Trust, said: “The CQC report identifies a number of key areas for further improvement and development which are needed for the trust, as well as recognition of the work which took place to embed a culture of compassionate care and treatment across all departments of the trust.
“The report illustrates areas where progress still needs to be made to ensure that the trust can provide the highest quality of treatment to the local community, which we are committed to providing. In our maternity ward, we have put in place and continue to develop measures to ensure that we can always provide patients with the safe and effective care they have come to expect.
“Despite unprecedented pressure, the Trust’s emergency and emergency services have been able to maintain a ‘good’ performance in providing efficient and caring care, which is a testament to the professionalism and commitment of our staff. .
“We are now working hard in full confidence to implement the recommendations of the CQC, so that we can continue to make improvements and provide increasingly high quality care to our communities in the future.”