England’s Chief Inspector of Hospitals has rated the services provided by The Pennine Acute Hospitals NHS Trust as Requires Improvement following inspection by the Care Quality Commission. Overall, the trust has improved, moving from Inadequate to Requires Improvement.
A team of inspectors visited North Manchester General Hospital, The Royal Oldham Hospital and Fairfield General Hospital - between17 October and 16 November 2017. The inspections were unannounced.
At North Manchester General Hospital CQC inspected urgent and emergency care, medical services, maternity and children and young people because these services were rated as inadequate at the last inspection. Inspectors also looked at surgical services which were rated as requires improvement. Overall, this hospital is now rated as Requires Improvement.
At the Royal Oldham Hospital CQC inspected critical care services, maternity and children and young people which were rated as inadequate at the last inspection. CQC also inspected urgent and emergency services, medical services and surgery which were rated as requires improvement. Overall, the rating for the Royal Oldham Hospital has improved to requires improvement
At Fairfield General Hospital CQC inspected urgent and emergency care, medical services and surgery because these services were rated as Requires Improvement at the last inspection. The overall rating for Fairfield, has improved to good. CQC did not inspect Rochdale Infirmary or Community Services which were rated as good overall at the last inspection.
Overall, the rating of the trust has improved, from inadequate to requires improvement. CQC rated safety, effectiveness and responsiveness as requires improvement. Caring and well led were rated as good.
There are now no longer any services across the trust’s hospitals that are rated Inadequate.
Summary of findings
At trust level the rating of safe has improved to Requires Improvement. The trust controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
Although staffing levels had improved, the trust still did not have enough staff of the right qualifications, skills, and training. Staff numbers across the trust were lower than planned in medical care, surgery, critical care and children and young people services.
The trust rating for caring overall improved to Good. Across the trust, the rating for well-led had improved from Inadequate to Good
Ellen Armistead Deputy Chief Inspector, Hospitals for the North, said:
“I am pleased to report that we have found evidence of real improvement in care at The Pennine Acute Hospitals NHS Trust. However, there remains a considerable amount to do to improve services for patients
“During the last inspection in 2016, we decided against placing the trust in special measures because Salford Royal NHS Foundation Trust had recently assumed leadership of the trust.
“A comprehensive plan to deal with the challenges faced by Pennine Acute Hospitals has been put in place and it is clear these arrangements have had a positive effect. We found a supportive and open culture that was focused on learning and improvement. While there had been major changes to the leadership and management at the trust, staff talked positively about local leadership.
“There is still considerable scope for improvement in the day to day delivery of services – and I look forward to reporting further progress as the trust deals with these matters in future.”
North Manchester General Hospital
The rating for this hospital improved from Inadequate to Requires Improvement.
Inspectors found that urgent and emergency care services, medical care, maternity and children and young people’s services had improved. Although staffing levels were better. the trust still did not have enough staff of the right qualifications, skills, and training. Staff numbers across the hospital were lower than planned.
There was evidence of good multidisciplinary working in most areas, and inspectors were told by patients and families during the inspection of positive examples of caring, compassionate care and maintaining privacy and dignity. Patients gave positive feedback about the care they received.
Staff talked positively about local clinical ward based leadership at North Manchester hospital. The leadership teams had an understanding of the current challenges and pressures impacting on service delivery and patient care
The Royal Oldham Hospital
The rating for this hospital has improved from Inadequate to Requires Improvement. Of the services inspected, emergency services, critical care, maternity and children and young people had improved and surgery had stayed the same. Inspectors saw that there had been some improvement to ensure there was medical leadership on the High Dependency Unit since the last inspection, although cover was only from 8am to 6pm.
Staff talked positively about local clinical ward based leadership at Royal Oldham hospital. The leadership teams had an understanding of the current challenges and pressures impacting on service delivery and patient care.
Fairfield General Hospital
The rating for this hospital has improved from Requires Improvement to Good. Urgent and emergency services and medical care had improved, with medical care being rated as outstanding. Surgery has stayed the same since the last inspection.
Due to workforce and resource limitations, seven day working had not been fully embedded across all service work streams. In addition the theatre environment was not fit for purpose and it was not clear when proposed refurbishment would take place. However, the trust confirmed that the refurbishment work was completed in December 2017
Medical and nurse staffing had improved across services. Where there were gaps shifts were covered by overtime and agency staff and recruitment was continuing. Services were planned in a way to meet the individual’s needs and the local population.
CQC noted some areas of outstanding practice:
- Across all hospital sites staff managed a recent major incident where they had received a number of critically injured trauma patients. Staff worked in an outstanding way to deliver care and treatment.
- In the therapies and Red Cross team at The Royal Oldham Hospital staff worked effectively to facilitate earlier discharge of vulnerable patients. This meant that necessary equipment could be transferred to the patient’s home, and patients were supported following discharge
- At North Manchester General Hospital, Urgent and emergency care had a bespoke sensory room for use with children who had a range of sensory impairments, including children on the autistic spectrum and children with learning disabilities. The room had been co-produced with patients and families and provided outstanding facilities
- At Fairfield General Hospital, the urgent and emergency care department worked closely with the medical wards to implement the golden patient initiative. This aimed to identify one patient per ward who could be safely discharged before 10am each morning. This provided up to eight beds to transfer overnight patients requiring admission out of urgent and emergency care each morning.
Ends
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