CQC warns Barts Health NHS Trust that it has failed to protect the safety and welfare of patients at Whipps Cross University Hospital

14 August 2013

The Care Quality Commission has told Barts Health NHS Trust that it must make urgent improvements to protect patients at Whipps Cross University Hospital.

CQC has issued three formal warnings to the trust following unannounced inspections at the hospital in Leytonstone in May and June. The team included experts by experience (people with experience of using services), a practising midwife and a practising surgical unit manager.

The warning notices set out the hospital’s failure to meet national regulations in three specific areas:

• Cleanliness and infection control
• Safety, availability and suitability of equipment
• Support to staff

Initially, inspectors visited the accident and emergency, elderly and outpatients departments over two days. They spent a further two days in the maternity and surgery departments.

Overall, the hospital was failing to meet 10 of the 16 national standards of quality and safety. Reports from both inspections have been published on the CQC website today.

Read the reports Whipps Cross University Hospital.

Matthew Trainer, Regional Director of CQC in London, said,

“We have very serious concerns about the care and treatment patients have been receiving at Whipps Cross University Hospital. The reports we have published today show a systematic catalogue of failings across the departments we looked at during our inspections in May and June.

“We found that, in places, the hospital was unsafe and dirty, and that staff didn’t always show patients the compassion that people deserve. Patients were not receiving the care and support they should have been able to expect – and in some cases, this was putting them at risk of harm. If staff have uncaring attitudes, are not supported properly to do their job, or if they are not properly supervised, the consequences for patients can be very worrying.

“Until now, there has been a failure to deal with these issues and urgent action must now be taken by the trust. Patients are entitled to be treated in services which are safe, effective, caring, well run, and responsive to their needs. The people of east London deserve better from their local hospital.”

Among CQC’s findings:

• Inspectors found that patients were spending too long in A&E. The hospital had not met the national target (95%) for patients to be seen within four hours for six months at the time of the inspection, and between January and March 2013 there had been 31 occasions when a patient had to wait more than an hour for handover to be completed after arriving in an ambulance. Some patients who had been waiting in in A&E for long periods were not always offered adequate food and drink.
• Inspectors found that patients on the elderly care wards did not always receive appropriate care and treatment. On a number of occasions, there were not enough staff on duty to meet patients’ needs. Care plans were not always updated as needs changed and risks were not always adequately assessed. Patients sometimes had to wait for support to eat their meals, or did not receive support at all, and water was sometimes placed out of reach. Some wards had to share equipment due to shortages. Support provided to staff in terms of appraisals and professional supervision was inadequate, and had been for some time.
• Inspectors found a number of significant shortfalls in the maternity department. Some women on the post natal ward received poor care. Staff were seen on occasions not to be supportive, considerate to women’s needs or compassionate. Some emergency neo-natal equipment had not been checked which could have resulted in delays in care if found to be faulty when it was needed. New-born babies and mothers were not protected from the risk of infection. The maternity wards were dirty in places, with overfilled bins and stained floors, walls and curtains. Infection control practice amongst staff was observed to be poor on some occasions. Records did not always reflect women’s current health status. There was not always a doctor available in the triage area of the labour ward, which meant that some women had to wait up to four hours to be seen.
• Inspectors found that care and treatment in the surgery department was not always planned and delivered in a way which ensured people’s safety and welfare. Paediatric life support trained staff were not always available in the paediatric theatres. On the Sage and Sycamore wards staffing was inadequate, as it did not enable staff to meet the needs of patients. There was high agency usage, and high staff turnover on both Sage and Sycamore wards. Inspectors were concerned about poor outcomes after surgery as the mortality rate was higher than the national average.
   

Matthew Trainer continued,

“Two weeks ago Sir Mike Richards, CQC’s new Chief Inspector of Hospitals, identified Barts Health NHS Trust as one of the first high risk trusts to be looked at under radical changes to the way hospitals in England are inspected.The problems we’ve identified today at Whipps Cross University Hospital suggest that that this wider review of how the trust functions is much needed.

“In any case, our inspectors will return unannounced in the near future to check that it has made the changes required by the warning notices.”

Ends

For further information please contact the CQC press office on 0207 448 9239 or out of hours on 07917 232143.

Notes to editors

CQC has published a full report Whipps Cross University Hospital.

Over two inspections in May and June 2013, inspectors found that Barts Health NHS Trust was failing to meet ten standards at Whipps Cross University Hospital.

At the May inspection the A&E, elderly and outpatients departments were failing to meet the following standards:

• Care and welfare of people
• Meeting nutritional needs
• Safety, availability and suitability of equipment
• Staffing
• Supporting workers
• Assessing and monitoring the quality of service provision

At the June inspection the maternity and surgery departments were failing to meet the following standards:

• Respecting and involving people
• Care and welfare of people
• Cleanliness and infection control
• Safety and suitability of premises
• Safety, availability and suitability of equipment
• Staffing
• Assessing and monitoring the quality of service provision
• Records

At the May inspection the A&E, elderly and outpatients departments were found to be meeting the following standards:

• Respecting and involving people
• Cooperating with other providers
• Cleanliness and infection control
• Management of medicines

At the June inspection the maternity and surgery departments were found to be meeting the following standards:

• Consent to care and treatment
• Supporting workers