The report that will appear on CQC's website tomorrow can be accessed in advance via the link at the bottom of this release (after the notes to editors) marked “Click here for report'.
The Isle of Wight NHS Trust has been rated as Requires Improvement following a Care Quality Commission (CQC) inspection.
Between 14 May and 20 June CQC inspected the trust’s mental health, community, ambulance and primary care services (NHS 111 and urgent care service) as well as five of the trust’s acute core services. These services included urgent and emergency care, surgery, gynaecology, medicine and end of life care. CQC also looked specifically at management and leadership to answer the key question - Is the trust well led?
CQC has also published the trust’s Use of Resources (UoR) report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Inadequate for using its resources effectively. The combined rating for the trust, considering CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Requires Improvement.
Inspectors found that a number of improvements had been made and embedded at the trust since their previous visit in January 2018, but that further improvements were required. As a result of the work done to date, the trust’s overall rating has been upgraded from Inadequate to Requires Improvement.
The Isle of Wight NHS Trust is also rated as Requires Improvement for whether its services are safe, effective and responsive and well led. It is rated as Good for whether services are caring.
As this is a combined trust, each service type was also rated:
Acute services were rated as Requires Improvement overall. This was an improvement since the last inspection. They were also rated as Good for being caring.
Community services were rated as Good overall, this was an improvement from the last inspection.
Mental Health services remained as Inadequate.
Ambulance services were rated as Requires improvement overall.
The NHS 111 and Out of Hours services were both rated as Good
Dr Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals, said:
“At this return visit to the Isle of Wight NHS Trust we found a number of improvements had been made. However, there are areas where further work is needed and the trust must ensure it continues to make changes that will lead to sustainable improvements, so that people receive the care they should be able to expect.
“Although there has been progress in addressing some of the immediate issues, we felt that it is still too early to judge their effectiveness and for that reason I believe the trust should remain in special measures for now.
“In particular, the trust needed to ensure there were sufficient and suitably qualified staff available and that systems to guard against risks were fully embedded to ensure patients were protected from avoidable harm.
“Since our last inspection in January 2018 the trust had formed an experienced leadership team with the skills, abilities, and commitment for the potential to provide high-quality services. The culture at the trust had been improved.
“We have given our feedback to the trust and we will return to carry out further inspections to check on its progress with improvement.”
Inspectors found ongoing issues with patient flow through the hospital and a high number of patients at admissions. This resulted in delays for patients to receive care and treatment and for some being nursed in non-patient bed spaces, which risked patient safety.
Inspectors found staff were not fully completing patient records or following up the processes when they identified a patient who was deteriorating. Once patients were admitted to the hospital, it was found, they could experience delays in their care and treatment; inspectors have issued a warning notice to the trust’s acute services at St Mary’s hospital.
Additionally, there were not always enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
Inspectors still had significant concerns about the community mental health services for adults of working age and the wards for older people with mental health problems. Warning notices against both services, requiring significant improvement have been made to the trust. There were also concerns about the safety of the long stay rehabilitation wards and the acute wards for adults of working age and psychiatric intensive care unit.
However, within the emergency call centre, service leaders had developed ways to celebrate success. Staff pin badges were presented to staff for the call handlers who managed successful calls such as those who had started cardiopulmonary resuscitation (CPR) on a call and the patient survived to be discharged from Hospital ROSC (Return of spontaneous circulation).
In end of life care there was innovative partnership working between the trust and the local hospice. This allowed for improved patient care locally. Business cards and postcards with information on how to access the team and their services were available to patients, relatives and carers. These postcards could be completed while patients and those closest to them were still in hospital. It enabled the staff to address any issues or concerns at the earliest opportunity.
Patient Transport Systems staff provided compassionate personalised care and considered patients’ wellbeing. This included staff ensuring patients had necessary food supplies when they dropped them off. Additionally, one patient who had commented they had not seen the sea for a long time due to their age and infirmity, was driven home along the sea front
Full details of CQC’s inspection, its ratings for the trust, including a ratings grid, are given in the report published online at: www.cqc.org.uk/provider/R1F
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