England’s Chief Inspector of Hospitals has rated the services provided by The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust as Inadequate following an inspection by the Care Quality Commission.
As a result it is recommended that the trust should be placed in to special measures.
The trust was inspected between 4 April and 21 June 2018. Inspectors highlighted a number of concerns and areas for improvement and the trust is now rated as Inadequate overall.
It is rated as Inadequate for whether the trust’s services are safe and well-led, Requires Improvement for whether its services are effective and responsive but Good for whether its services are caring.
The trust, which is in Norfolk, was rated Requires Improvement following its inspection in June 2015.
CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said
“On our return to the The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust found there had been a deterioration in the service provided since our last visit and a number of improvements were needed.
“Our inspection found concerns in urgent and emergency care, maternity and medical care. All three departments are now rated as Inadequate overall following our inspection and surgery, which was previously rated as Good, is now rated as Requires Improvement.
“Our concerns in relation to the maternity service were such that we raised these with the executive directors while on site, issued a warning notice to the trust, identifying areas where it must improve, and placed conditions on the trust’s registration. We know the trust initiated an immediate action improvement plan for maternity services and we will return to check on improvements in the service.
“We have reported our findings to the trust leadership and it knows what it must do now to bring about the necessary improvements. We will continue to liaise with NHS Improvement with regard to the trust and its progress and our inspectors will return in due course to check on whether the improvement needed has taken place.”
The trust has been told it must make improvements in a number of areas and this includes that patient care records must be accurate, complete and contemporaneous, including those relating to weight and nutritional assessments and fluid balance charts. Mental capacity assessments must be consistently and competently carried out where required.
The trust must review the knowledge, competency and skills of staff in relation to the Mental Capacity Act and Deprivation of Liberty safeguards and ensure that there is an effective process for governance, quality improvement and risk management in all departments.
Processes for incident reporting, investigation, actions and learning must be embedded across all services. And serious incidents must be identified, reported and investigated in a timely manner.
The duty of candour must be carried out as soon as reasonably practicable and the trust must ensure clear processes are in place for sharing learning from incidents, complaints and audits with staff.
The trust must ensure that the information used to monitor, manage and report on quality and performance is accurate, valid, reliable, timely and relevant.
It must improve the culture, working relationships and engagement of consultant staff across all services and make sure effective process for managing staff grievances and complaints are in place.
However, we found outstanding practice in the multi-disciplinary rapid assessment team which worked in the emergency department to help patients who didn’t need to be admitted avoid being admitted to hospital or swift discharge for patients who were able to be discharged.
Full details of the ratings, including a ratings grid, are available. Read the report.
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...there had been a deterioration in the service provided since our last visit and a number of improvements were needed
Professor Ted Baker, Chief Inspector of Hospitals