The Care Quality Commission (CQC) has published a report following an inspection of services at Arrowe Park Hospital in the Wirral, provided by Wirral University Teaching Hospital NHS Foundation Trust in October.
CQC carried out an unannounced inspection of urgent and emergency services and medical care after receiving concerns about the quality and safety of these services.
Following this inspection, the rating for medical care improved from requires improvement to good overall. It is also rated good for being effective, caring, responsive and well-led. The rating for being safe has not changed and remains as requires improvement.
The rating for urgent and emergency services remains as requires improvement overall, as well as for being safe and responsive. The ratings for effective and well-led improved from requires improvement to good and caring remains as good.
The overall rating for the trust remains as requires improvement.
Karen Knapton, CQC’s head of hospital inspection, said:
“When we visited Arrowe Park Hospital, we saw that the leadership team had taken action to address the issues raised at the previous inspection. We were pleased to see staff were focused on meeting the needs of patients and were clear about their roles and responsibilities. This work has resulted in the rating for medical care moving up from requires improvement to good and both medical care and urgent and emergency services continuing to be good at caring for patients.
“In medical care we found improvements with bed management as well as patient discharge. This included, patients who had a stroke followed a pathway where they were reviewed in the emergency department by a stroke co-ordinator, then transferred to the stroke unit in a timely way. Patients with dementia were admitted directly on to the older people’s wards from the emergency department to try and reduce their movement around the hospital.
“Additionally, patients being discharged were given food to take home if they were unable to go to the shops, to make sure they had their basic needs met.
“In urgent and emergency services we found a mixed culture. Not all staff we spoke with felt respected and supported by managers, and some told us they did not always feel that the culture enabled them to raise concerns. The leadership team were aware of this and told us they were taking action to address these concerns.
“There were also some concerns about the environment in the department. It was not well signposted; people were seen getting lost and accessing restricted areas. Also, the mental health assessment room required improvement to ensure that staff and patients were safe, and patients’ privacy could be maintained.
“I recognise the enormous pressure NHS services are under across the country and that usual expectations cannot always be maintained, especially in urgent and emergency services. It’s important that the trust does all they can to mitigate risks to patient safety, this didn’t always happen.
“We found patients often had a long wait for admission, one person waited over 14 hours to be admitted on to the ward, which is unacceptable and must be addressed as a matter of urgency.
“Overall, the trust had made improvements to the services we inspected. We will continue to monitor the trust closely to ensure these improvements are embedded and sustained and that that further improvements are ongoing.
Inspectors found:
- Staff did not always identify and quickly act upon patients at risk of deterioration in the urgent and emergency department waiting room
- The medical care service did not always have enough staff to care for patients. Not all staff had training in key skills, mandatory training compliance for medical staff did not meet trust targets
- People could not always access services when they needed them. Patients did not always receive timely care and treatment. Waiting times were not always in line with national standards, this has been impacted by COVID-19.
However:
- Staff understood how to protect patients from abuse, and managed safety well
- Staff gave patients enough to eat and drink and gave them pain relief when they needed it. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers
- The service planned care to meet the needs of local people, considered patients’ individual needs, and made it easy for people to give feedback.
Full details of the inspection are given in the report published on our website.
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