The Care Quality Commission (CQC) has rated the quality services provided by Yeovil District Hospital NHS Foundation Trust as Requires Improvement overall following an inspection in December 2018 and January 2019.
While the overall quality rating remains unchanged, inspectors noted clear progress in a number of areas since its previous inspection. The trust is now rated as Good for being caring, effective and responsive and is rated as Requires Improvement for being safe and well-led.
A team of inspectors visited the trust to check the quality of five core services: urgent and emergency services; medical care; maternity; services for children and young people; and end of life care. CQC also looked specifically at management and leadership to answer the key question: Is the trust well-led?
Yeovil District Hospital, the trust’s main centre, was rated as Good for being effective, caring, responsive and well-led. The hospital was rated Requires Improvement for being safe. Overall, the hospital is now rated as Good, a step up from its previous rating of Requires Improvement.
CQC has also published the trust’s Use of Resources (UoR) report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Inadequate for using its resources productively. The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Requires Improvement.
You can read the latest reports in full here: www.cqc.org.uk/provider/RA4, once the report has been published on the CQC website.
Dr Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals, said:
“Yeovil District Hospital NHS Foundation Trust has worked incredibly hard to embed the improvements we requested from our previous inspections and I want to congratulate the trust for the work done and for its consistent work with other organisations to improve the services offered to the local community.
“Staff have worked hard to transform the emergency department and it is now rated Good with an Outstanding rating for responsiveness. The department not only achieves national standards for treatment and response times but is in some areas exceeding these standards and this too should be congratulated.
“I am encouraged by the progress that has been made but there remains plenty of scope for further improvement, particularly in relation to ensuring sufficient oversight of risk which is an area the trust must address.
“Nevertheless, our inspectors found an exceptionally strong patient-centred culture with staff putting patients first to keep them safe and involving them in decisions which affected their treatment and care.
“We will continue to monitor the trust’s performance and will return to hopefully report on further improvements in due course.”
Within the Emergency Department, the needs of local people were central to the planning and delivery of services. The department had reviewed and made changes in response to patient needs and demands. Patients were streamed and assessed to ensure they were transferred to the most suitable area and to help reduce unnecessary hospital admissions.
Inspectors found improvements in medical care. The leadership had developed a culture that supported the delivery of high-quality care. There were clear processes from ward level up to the trust board. The trust worked well with the local authority and other providers to deliver high quality services. However, there was insufficient detail in the medical records of some patients around assessment of mental capacity and when a patient showed signs of deterioration.
Children, young people and their families and carers were treated by staff with compassion, kindness, dignity and respect. There was a happy atmosphere on the ward and children and young people were engaged in activities. Staff offered emotional support and reassurance to children, young people and their relatives and carers to minimise their distress. There were still issues within the children’s ward which impacted on the safety of children and young people. These had not been fully addressed, although the senior leaders had submitted a business plan which would reconfigure the layout the ward and lessen many of the risks. This was yet to be approved.
In maternity, inspectors found numerous examples where staff had ‘gone the extra mile’ and exceeded the expectations of women and their partners. Women told inspectors they viewed their midwives as friends and advocates. Staff were proud of the relationships they formed with women and their families.
People received individualised end of life care by staff in the ward areas where the patients were admitted. The specialist palliative care team reviewed all patients as soon as possible when they received patient referrals. The trust planned and provided services in a way that met the needs of local people. This included a strategy to improve recognition of people in their last year of life to enable people to be involved in decisions about their care. As with medical care, we had concerns about some of the patient’s records, and also with the management of syringe drivers for pain relief.
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