CQC rates Wye Valley NHS Trust as Inadequate and recommends trust remains in special measures

England's Chief Inspector of Hospitals has recommended Wye Valley NHS Trust remains in special measures after a Care Quality Commission (CQC) inspection resulted in it receiving an overall rating of Inadequate.

During the inspection in September and October 2015, CQC inspectors found the trust needed to make a number of significant improvements to ensure it was consistently delivering care which was safe, effective, responsive to people’s needs and that it was well led.

The trust was placed into special measures in October 2014 following a CQC inspection in June of that year.

When inspectors returned to the trust for this most recent inspection they found that although there were some improvements there were a number of areas of significant concern.

Improvements were seen in community services, which overall were rated as Requires Improvement, with community health services for adults, children, young people and families, and community dental services being rated Good. All services were rated Good for being caring.

However there were concerns at Hereford Hospital which was rated Inadequate overall.

Following the inspection, the trust was issued with a warning which told the trust to make significant improvements with regard to its systems to assess, monitor and mitigate risks relating to the health, safety and welfare of people receiving care.

Inspectors were also concerned systems, including those to ensure patients were protected from abuse and avoidable harm, were not operating effectively.

There were not always sufficient numbers of suitably qualified, competent, skilled and experienced staff available. Additionally patients were waiting too long to access services at the trust and that this was being poorly managed.

The trust has been given detailed feedback on CQC’s findings and told to address these issues as a matter of urgency.

Professor Sir Mike Richards, the Chief Inspector of Hospitals, said:

“We found a number of significant issues when we inspected the services run by Wye Valley NHS Trust. I am concerned the systems to protect patients from harm were not effective and that governance arrangements did not always ensure that when things went wrong they were investigated and that the trust learned from these. This was particularly evident in maternity services.

“While we found the trust is rated as Good for being caring, with caring in community adults services found to be Outstanding, there were not always enough suitably qualified and skilled staff available.

“The trust overall is rated Inadequate for safety and responsiveness and as Requires Improvement for responsiveness and being well-led.”

The trust has told CQC that it has already taken action to address the Commission’s concerns and has developed a detailed weekly improvement plan and submitted evidence with regard to these.

CQC will continue to work with the trust and the Trust Development Authority to monitor the trust’s progress.  If there is no improvement, CQC will consider what further steps are needed to ensure improvement takes place at Wye Valley NHS Trust.

CQC has told the trust it must make improvements in a number of areas, which include:

• Where a person lacks capacity to make an informed decision or give consent the trust must ensure staff act in accordance with the requirements of the Mental Capacity Act 2005.
• All staff must be properly supported in their roles, undergo regular appraisals and receive mandatory training.
• The trust must ensure enough suitably qualified staff are on duty across its services, including having the appropriate number of qualified paediatric staff in the emergency department.
• Consultant cover must meet the Royal College of Emergency Medicine’s (RCEMs) emergency medicine consultant workforce recommendations.
• Ligature points must be identified and the risks associated with them mitigated to protect patients from harm.
• Incidents must be reported, including those associated with medicines, and the trust must ensure systems are in place to report, monitor and investigate incidents and share learning from them.
• All trust policies and standard operating procedures must be up to date and consistently followed by staff.
• Medicines must be prescribed and stored in accordance with trust procedures.
• Patient records, including Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) forms and prescription charts, must be accurate and stored appropriately to protect confidential data.
• Risk assessments must be completed in a timely manner and used effectively to prevent harm.
• Staff must check the site to be operated on in surgery to ensure this is appropriately marked, prior to operations, and that this is documented.
• Clinicians must have access to all essential patient information, such as patients’ medical notes, to make informed judgements on planned care and treatment of patients.

Full reports including ratings of all core services have been published on this CQC website.

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