Care Quality Commission publishes report on Royal Lancaster Infirmary

23 June 2011

Care Quality Commission (CQC) inspectors have found that the Royal Lancaster Infirmary, part of the University of Morecambe Bay NHS Foundation Trust, is failing to meet a number of essential standards of care for patients.

CQC carried out a review at the Royal Lancaster Infirmary on 20 April 2011 as part of our routine schedule of planned reviews of NHS organisations.

CQC inspectors reviewed all the information we hold about this provider, carried out a visit in April 2011, observed how people were being cared for, talked to people who use the services, talked to staff, and checked the provider’s records.

The CQC report highlights the regulator’s concerns with three areas that require improvement and a further seven where we have suggested improvements. The areas the inspector looked at are:

• Food and drink should meet people’s individual dietary needs
  We found that tools were in place to ensure nutritional risk assessment and for recording nutrition and hydration but the effectiveness of these and the standards of individual practices on the wards was not always of a consistently good standard. As a result patients were not always being well supported individually to have adequate nutrition and hydration. People using the service could not be confident that they would be supported to eat their meals according to their ability and to maintain their dignity and independence or that their nutritional intake would be monitored
  Overall, we found that improvements were needed for this essential standard.
• There should be enough staff to keep people safe and meet their health and welfare needs
  We found that the current staffing arrangements in the orthopaedic wards we visited, while adequate to provide basic care, were not sufficient to meet the individualised and holistic needs of people using the service at all times. The management needs to review the present structures to ensure staffing levels are constantly monitored and they have plans in place to deal realistically with unexpected changes in staffing circumstances. This way people using the service would benefit from having sufficient staff available to be able to treat them as individuals and improve the work environment for the staff themselves.
  Overall, we found that improvements were needed for this essential standard.
• People should have their complaints listened to and acted on properly
  We found that the ward staff try to resolve individual’s complaints at ward level where they can. There are up-to-date and comprehensive systems and monitoring in place to deal with complaints across the trust as a whole. The information we have indicates that overall the trust does not always act promptly to coordinate a response to an escalated complaint. Evidence of improvement needs to be shown so people can have confidence in the system that is in use within the trust’s complaints department.
  Overall, we found that improvements were needed for this essential standard.

With regard to seven other standards, we judged the provider could do more to ensure future compliance and we have suggested improvements. These were with regard to:

• respecting and involving people who use services.
• consent to care and treatment.
• care and welfare of people who use services.
• cooperating with other providers.
• cleanliness and infection control.
• assessing and monitoring the quality of service provision and records and record keeping.

CQC Regional Director for the North West, Sue McMillan says, “The hospital needs to focus on the three areas of non-compliance. The onus is now on the trust to ensure that it addresses these areas in a timely manner.

I am confident that through working with NHS North West the trust will take the necessary action to comply with current standards and sustain improvements for patients. CQC will check this has happened through its continued monitoring of the trust.”

Ends

For further information please contact David Fryer Regional Communications Manager 07901 514220 or the CQC press office on 0207 448 9239 or out of hours on 07917 232 143.

Notes to editors

Under the Health and Social Care Act 2008, the Care Quality Commission has a number of enforcement powers to deal with services that are not meeting essential standards of quality and safety. In the most serious cases, the Commission can prosecute or cancel registration.

Any regulatory decision that CQC takes is open to challenge by a registered person through a variety of internal and external appeal processes.