Chief Inspector of Hospitals recommends Walsall Healthcare NHS Trust should be placed into special measures

England's Chief Inspector of Hospitals has recommended Walsall Healthcare NHS Trust should be placed into special measures after a Care Quality Commission inspection rated the trust as Inadequate overall.

Following inspections carried out in September, CQC found the trust - which provides acute hospital and community health services for around 260,000 people living in Walsall and the surrounding areas - needed to make urgent improvements to ensure it was consistently delivering care which was safe, effective, caring, responsive to people’s needs and was well-led.

Inspectors had concerns about the trust’s staffing in a number of areas. Workloads in the emergency department and maternity were seen to have resulted in care falling below the standards patients should be able to expect and incident reporting was seen to be variable across the trust.

Following the inspection CQC issued a warning to the trust demanding that urgent improvement took place.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“We found a number of serious problems when we inspected the services run by Walsall Healthcare NHS Trust and I have made a recommendation to the Trust Development Authority that the trust should be placed into special measures.

“We made the TDA aware of our concerns following the inspection and it has started to work with the trust to make sure these are appropriately addressed and that progress is monitored.

“Following our inspection we issued the trust with a warning setting out that significant improvement was immediately required in a number of areas including maternity services and emergency care.

“However, we found that in many areas staff were dedicated and committed to patient care despite the pressures of staff shortages.

“The trust has responded to our inspection findings and warning with a detailed plan for remedial action and we will return to undertake further inspections, including unannounced visits, to check that the necessary improvements have been made.”

The inspection highlighted a number of concerns and areas where the trust must improve, including:

• Governance of incident reporting systems needed to improve to ensure processes were embedded across the trust.
• Duty of candour training needed to improve to ensure staff had a clear understanding of the process.
• Training for complaints investigation, to improve the dissemination of lessons learned to front line staff and their managers, needed to be properly implemented.
• Adequate numbers of qualified staff needed to be made available across all services, particularly in maternity services and the emergency department.
• Equipment needed to be kept in good working order and fit for purpose across all services and be stored appropriately; keeping all fire exits free from obstruction.
• Mental Capacity Assessments (MCA), Deprivation of Liberty Safeguards (DoLS) and Do Not Attempt CPR (DNACPR) assessments must be carried out in a timely manner and supported by appropriate documentation.
• The patient administration system needed to be reviewed to minimise problems associated with missed patient appointments and its data needed to be accurate.
• The trust needed to ensure health records were completed appropriately and maintain patient confidentiality at all times.

An inspection team, including doctors, nurses, midwives, trained members of the public, a variety of specialists, CQC inspectors and analysts spent three days at the trust between 8 and 10 September as part of an announced inspection. Three unannounced visits also followed as part of the same inspection on 13, 20 and 24 September 2015.

The inspection looked at services at Walsall Manor Hospital, community end of life services, community services for children young people and families and community services for adults.

The trust was rated as Inadequate for being safe, effective and well-led and rated as Requires Improvement for being caring and responsive.

Full reports will be published on the CQC website at: www.cqc.org.uk/provider/RBK.

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