England's Chief Inspector of Hospitals, Professor Sir Mike Richards, has published his first report on the quality of care provided by United Lincolnshire Hospitals NHS Trust, and recommends the trust should remain in special measures for a further six months.
The trust was placed into special measures by Sir Bruce Keogh, following an inspection by his team, last year after concerns were raised about mortality rates and standards of care.
Under its new inspection model, CQC has given individual ratings to each of the core services at the trust’s hospitals, accident and emergency (A&E), medical care (including older people’s care), surgery, critical care, maternity and family planning, services for children and young people, end of life care, and outpatients.
Pilgrim Hospital, Grantham and District Hospital, Lincoln County Hospital and Louth Hospital, were all rated as Requires Improvement overall, following CQC’s inspection which took place between 29 April and 2 May and on 11 May.
Both Grantham and Pilgrim hospitals were rated as Good for end of life care and outpatients. Grantham Hospital was also rated as Good for surgery, while Pilgrim Hospital received a Good rating for its critical care services.
Lincoln County Hospital was rated as Good for its critical care but Inadequate for its outpatient services.
All other services inspected were rated as Requires Improvement and the overall rating for the trust as a whole is Requires Improvement. The trust was rated as Good with regard to whether services were caring.
Full reports for the trust and each of its hospitals can be found on CQC’s website at United Lincolnshire Hospitals NHS Trust
Among our inspectors’ concerns were that some processes were not being embedded across the trust and recruitment of staff was a challenge, with a number of vacancies at Pilgrim Hospital.
The trust has been told that it must make improvements to ensure that:
- There is an accurate record of each person’s care and treatment.
- There are sufficient staff to meet the needs of patients receiving treatment.
- Equipment and the environment is adequately maintained to ensure the safety of patients.
- Staff are appropriately trained and receive supervision.
- Processes for the safe prescribing, recording and administration of medications are maintained.
- There are appropriate governance processes to learn from incidents, so that patients are protected from the risk of harm.
Inspectors found services across the trust were caring, and rated these as Good. Nursing staff were seen to be caring and compassionate and staff were seen to be committed and proud to work for the trust. Patients were also found to be supportive of the trust.
Inspectors also found outstanding practice in the intensive care unit where there were separate areas for male and female patients, which allowed people to maintain their privacy and dignity.
Additionally, patients who had complained about their care were used in the recruitment and selection of new staff.
While the majority of patients and relatives told inspectors they felt safe at Lincoln County Hospital, some of the feedback, from patients and relatives at the hospital’s Stow Ward, was poor. The trust took immediate action to rectify this and on CQC’s unannounced visit to the hospital inspectors found the experience of patients using the ward had improved.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “I recognise the leadership team at United Lincolnshire Hospitals NHS Trust has been working hard over the last year to make improvements. While we saw definite evidence of improvement, the trust still has some way to go before it reaches the required standard. In particular, medical staff need to be better engaged in improving service quality and better integration of clinical services between the hospital sites is needed.
“That is why I have recommended to the Trust Development Authority that the trust remains in special measures for a further six months. I hope that, in six-month’s time, the trust will be able to demonstrate enough improvement to review this again.
People deserve to be treated in services which are safe, caring, effective, well-led, and responsive to their needs. We will continue to monitor the trust closely and this will include further inspections.”
Inspectors also visited Lincoln County Hospital unannounced on 11 May as part of the inspection, held focus groups with staff, and held a public listening event. The report which CQC publishes today is based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.
CQC inspectors will return to the hospital in due course to check that the required improvements have been made.
ENDS
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