CQC rates Homerton University Hospital NHS Foundation Trust as Good

Homerton University Hospital NHS Foundation Trust has been rated Good overall by the Care Quality Commission.

The Hackney based trust was rated Good in all categories - for being safe, effective, caring, responsive and well-led, following the inspection in April and May 2018.

CQC carried out an unannounced inspection of four core inpatient services at the main hospital site: emergency and urgent care (including A&E), medical care (including older people’s care), surgery and maternity services.

Inspectors rated urgent and emergency services as Outstanding overall, with an Outstanding rating applied to the caring, responsive and well-led domains. CQC also rated medical care (including care of the older person) as Outstanding overall, with an Outstanding rating applied to responsive and well-led domains.

The urgent care clinical quality group oversaw work in the emergency department. There was a cohesive and open approach to managing all aspects of the department including patient and staff safety; performance and sustainability.

The way in which the sepsis awareness training programme was delivered was innovative and interactive.

There were patient pathways and service level agreements in place which enhanced patient safety and the patient’s experience. These included rapid referral to other specialties and hospital admission avoidance.

In medical care the trust’s training programme and hospital facilities provided unique opportunities for learning and training for medical staff. For example, scenarios simulated a patient with complex care needs, and staff were able to work through how best to deliver treatment as a group.

In surgery the bariatric service was involved in a pan-UK wide study looking at bariatric surgery safety. Staff said this was one of the biggest studies in the world. Bariatric surgery consultants were involved in regional teaching of bariatric surgery consultants and doctors in training.

In maternity the service demonstrated excellent safeguarding practices and support for vulnerable women.

However, there were some areas where the trust should make improvements:

• These included concerns inspectors had surrounding the sustainability of the trust’s safeguarding team to ensure timely completion of safeguarding referrals and Deprivation of Liberty Safeguards (DoLS) assessments, monitor incidents, provide engagement with other agencies, ensure consistent delivery of training for staff, and ensure consistent provision of services for patients diagnosed with a learning disability.
• In urgent and emergency services the trust should ensure that all staff are clear about what communication aids are available to support and facilitate communication with patients with learning disabilities or communication difficulties.
• In medical services the trust should ensure that Mental Capacity Act assessments and DoLS applications are adequately completed and correctly recorded. The trust should ensure there is suitable provision on medical wards to support the care of patients diagnosed with a learning disability.
• In surgery services the trust should review consent training and processes to ensure all clinicians understand their responsibilities for obtaining consent. The trust should take steps to improve the facilities for relatives in the surgical wards and consider flexibility with visiting times to meet patient’s needs.
• In maternity services the trust should ensure sufficient numbers of appropriately skilled doctors and midwives are deployed to meet the needs of the service. Further action is needed to ensure consistent compliance with hand hygiene.

All other services at Homerton University Hospital were rated Good. However, CQC rated the well-led domain in maternity services as Requires improvement.

Professor Ted Baker, England’s Chief Inspector of Hospitals said:

“Staff and the management team at Homerton University Hospital NHS Foundation Trust have consistently provided a good standard of care to patients.

“I was pleased to see some areas where the quality of care and the evident innovation was outstanding, notably in surgery’s bariatric service.”

You can see the latest ratings tables on pages 13,14 and 15 of the inspection report.

Read the report

The CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. Various factors are considered by NHSI, including a combination of data on the trust’s financial performance over the previous 12 months, NHS Improvement’s local intelligence and the trust’s assessment of its performance. As a result of this review the trust has been rated as Good for use of its resources during the 2017/18 financial year.

The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHS Improvement’s assessment of the use of resources is Good.

Ends

For further information please contact Ray Cooling, Regional Engagement Manager (London), on 020 7448 9136 or call the press office on 020 7448 9401 during office hours. 

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