England’s Chief Inspector of Hospitals has rated the services provided by County Durham and Darlington NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission. Overall, the trust rating has remained the same.
A team of inspectors visited Darlington Memorial Hospital and University Hospital Durham between 12 September and 20 October. The inspections were unannounced. In respect of safety and effectiveness the trust was rated Requires Improvement and for caring and responsiveness and well led, Good.
Overall the rating for Darlington Memorial Hospital remained the same at Requires Improvement. CQC last inspected this service in 2015, overall urgent and emergency care, medical care and maternity services stayed the same.
Within urgent and emergency services at Darlington there had been improvement in leadership. The service had improved on many of the actions highlighted in the 2015 inspection report. Staff described the culture within the service as open and transparent; they felt they could raise concerns and felt listened to - leaders were visible and approachable.
Between October 2016 and September 2017 the department had only met the monthly 95% four hour target once. However, in most areas, nurse staffing had improved, care and treatment of patients requiring non-invasive ventilation had improved and staff investigated incidents quickly, and shared lessons learned and changes in practice with staff.
The rating for surgery went down from Good to Requires Improvement. Inspectors raised concerns with the trust that equipment servicing had not taken place. In addition, limited sepsis training was available to staff. Inspectors also noted that staffing levels at night and on late shifts fell below recommended guidance.
Within maternity services, Inspectors could see that there was a newly formed senior leadership team. There was a real drive to improve the quality of the service..
At the University Hospital Durham, the rating for services remained unchanged at Requires Improvement. Safety and effectiveness were Requires Improvement; caring and responsiveness; Good. Well led improved to Good Overall, surgery had gone down one rating to Requires Improvement, overall, urgent and emergency care stayed the same. Medical care had improved.
Medical care, including older people, had improved. Doctors, nurses and other healthcare professionals supported each other to provide care, all staff worked together as a team. Inspectors could see that procedures to protect vulnerable adults or children were well embedded.
Surgery at Durham had its rating downgraded from Good to Requires Improvement. When inspectors examined training records they found that theatre staff had not attended regular training, as they were too busy to attend. Overall compliance with mandatory training in surgery was 51% against a trust target of 95%.
Despite action being taken, at trust level, regarding never events, there was a need for further learning to be embedded to keep patients safe. A never event is a serious event that is entirely preventable.
Ellen Armistead, Deputy Chief Inspector, Hospitals for the North, said:
“Since our last inspection at County Durham and Darlington NHS Foundation Trust, in February 2015, the rating for trust has remained the same at Requires Improvement.
“We did see some improvement at Darlington; maternity services and leadership and medical care at Durham. It was encouraging to note that the leadership had improved across the trust, due to the implementation of the recommendations from the 2015 report. However, to see deterioration in surgery across the trust is a concern.
“However, there is still plenty of scope for the ratings of the trust to improve. I hope that before future inspections the trust can make further improvements so that it can improve the quality and safety of care the benefit of patients.”
"While we saw some improvements the pace of change needs to be addressed and the trust remains requires improvement overall. The trust will need to demonstrate they can address all outstanding areas for improvement since our last inspection and sustain the improvements we have reported on.”
For media enquiries, contact David Fryer, Regional Engagement Manager on 07754 438750 or david.fryer@cqc.org.uk
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. (Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.)
While we saw some improvements the pace of change needs to be addressed and the trust remains requires improvement overall.
Ellen Armistead, Deputy Chief Inspector, Hospitals