England's Chief Inspector of Hospitals has found Bolton NHS Foundation Trust to be Good following an inspection by the Care Quality Commission.
A team of inspectors has found the trust provided services that were caring, effective, responsive and well led but needs to improve on safety.
CQC inspected Bolton NHS Foundation Trust in March this year. Included in the inspection were Bolton One, community inpatients/adults and children and young people, and Royal Bolton Hospital which were rated as Good, and the trust’s child adolescent mental health service (CAMHS) was rated as Requires Improvement. Overall CQC rated the trust as Good.
Ellen Armistead, Deputy Chief Inspector of Hospitals at CQC said:
“We found the care at Bolton NHS Foundation Trust to be of a good standard. There was a clear vision and strategy for delivering the highest standards of patient care with risk management at the heart of everything the trust did.
“The trust are doing some outstanding work in the neonatal department especially with their ‘fresh eyes initiative’ where nursing staff look at other nurses’ patients at 1am and 1pm as an added layer of security to make sure nothing gets missed.
“We would like to see improvements in the Emergency Department at the trust, particularly to improve staffing levels, making it more sustainable reducing temporary doctor cover. We did observe that at the time of the inspection, all levels of staff were committed to covering these shortfalls themselves, however we were concerned with how this could be maintained.”
View the full report for the trust and its services visit on this website.
There was a positive culture and a sense of pride throughout teams across the trust, and inspectors saw that staff were committed to being part of the trust’s vision and strategy going forward. Inspectors found the trust to be well-led, and management had a clear commitment to quality, particularly around risk management. Staff we spoke to felt supported by their managers and supported and encourage to raise concerns and ideas.
Whilst most areas had sufficient numbers of medical staff to meet patient needs, which included the use of agency staff, there were pressures within the emergency department due to increased demand. Increased activity in the emergency department had meant that emergency department consultants were regularly working in place of middle grade staff to ensure the department continued to function with appropriate medical staffing levels. CQC observed that medical staff were committed to maintaining patient safety and worked well together as a team to ensure that rotas were covered.
Access and flow remained a challenge, and the emergency department did not, at times see, treat, admit or discharge patients within the national target of four hours. Plans were in place to expand the emergency department in order to accommodate the increase in patient attendances, including the increase in patients attending from outside of Bolton.
Inspectors saw some outstanding work on the neonatal unit. The trust were early adopters of the neonatal behaviour evaluation scale (NBES) which is a guide that helps parents, health care providers and researchers understand the new-born language. Additionally infection control work in the neo natal department was nominated for an award from the Health Service Journal (HSJ). The unit also introduced the ‘fresh eyes initiative’, which is where nursing staff look at other nurses’ patients at 1am and 1pm to promote things not being missed.
However there were some areas where the CQC requires the Trust to improve:
- Complete mental health assessment forms in the emergency department as soon as practicable and ensure these are distributed and used where appropriate.
- Improve staffing levels, and the focus on audits in the emergency department
- Ensure that robust information is collected, analysed, and recorded to support clinical and operational practice in medical services.
- Deploy sufficient staff with the appropriate skills on wards
- Ensure that records are kept secure at all times so that they are only accessed and amended by staff.
- Ensure that staff are up to date with appraisals and mandatory training in medical wards.
- Ensure that paper and electronic records are stored securely and are complete in outpatient’s areas.
Ends
For further information, please contact Kerri James, CQC Regional Engagement Communications Officer by email kerri.james@cqc.org.uk or by phone on 07464 92 9966.
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