England’s Chief Inspector of Hospitals has recommended that St George’s University Hospitals NHS Foundation Trust in Tooting, south west London, should be placed into special measures after an inspection by the Care Quality Commission rated the trust as Inadequate overall.
A team of inspectors found St George’s Inadequate for being safe and well-led. It was rated Requires Improvement for being effective and responsive. However, it was rated Good for caring.
Immediately after the inspection in June and July 2016, CQC issued a Warning Notice to the trust highlighting breaches in regulations related to: safe and fit premises at St George’s Hospital; obtaining consent under the Mental Capacity Act, 2005; good governance and the fit and proper person requirement.
Inspectors have today published a full report of the inspection which includes the ratings for individual services at the trust. You can read the full report on this website.
Professor Sir Mike Richards, the Chief Inspector of Hospitals, said: “I am disappointed that we have found a marked deterioration in the safety and quality of some of the trust’s services since we inspected two years ago, as well as in its overall governance and leadership.
“Our inspectors found that several of the trust buildings – including operating theatres – were in a state of disrepair which meant they were not fit for purpose. There were poor fire detection systems and a heightened risk of water contamination, which meant that people were put at risk.
“We also observed that not all staff followed infection control procedures, even when challenged by colleagues.
“Worryingly, we found that areas in which children and young people with mental health conditions were cared for had not been checked for ligature points, and that half of the medical staff working with children and young people had not completed level three safeguarding training, which is a requirement for all staff working with children.
“We took urgent action requiring the trust to address the most immediate of our concerns, and the trust has now introduced a range of supportive measures as a means of stabilising the organisation. I am aware that significant steps have been taken to strengthen leadership within the trust with an experienced interim chair having been appointed and several recent additions to the executive team.
“I am satisfied that the executive team acknowledge the need for significant improvement across the board and are clear about the challenges they face. They will need external support which is why I have recommended that the trust be placed into special measures.”
The emergency department was not large enough for the number of patients that passed through it and privacy and dignity were compromised. Inspectors also found that there was a lack of formal mental capacity assessments.
Leadership across several departments was weak. Black and minority ethnic staff were not given the opportunities that less experienced white staff had in some areas.
Fit and proper persons, which is a legal requirement for trusts to undertake, was not fully embedded in the trust.
The inspection has identified a number of areas for improvement including:
- The trust must develop a long term strategy and vision, with a stable, substantive leadership team
- Ensure all premises and facilities where healthcare is delivered and accommodates staff are safe, well-maintained and fit for purpose
- Medicines must be stored in an appropriate manner.
However, there were though several areas of outstanding practice. Outcomes for renal patients in relation to survival rates and transplants were excellent and one of the best in the country.
Other areas of outstanding practice included: the effectiveness of maternity care; the outcomes achieved by specialist medical and surgical services and the involvement of children of various ages on the interview panel as part of the recruitment process for emergency department paediatric nurses.
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