Croydon Health Services NHS Trust has been rated Requires Improvement overall by the Care Quality Commission.
The trust, which provides acute and community healthcare services across the London borough of Croydon, was rated Requires Improvement for being safe, effective and well-led. It was rated Good for being caring and responsive, following the inspection which took place in October and November 2017.
During this inspection CQC inspected Croydon University Hospital and Purley War Memorial Hospital.
The trust has 443 inpatient beds. The emergency department is at Croydon University Hospital. Purley War Memorial Hospital does not have any inpatient beds and services provided include phlebotomy and outpatient clinics.
CQC’s overall rating for the trust remains the same as it did in June 2015 - Requires Improvement.
Inspectors found there had been improvements in some of the services inspected, including surgery, outpatients and end of life care and their ratings had improved from Requires Improvement to Good, but further improvements were needed in several areas:
- There was a lack of awareness and understanding among some staff about the care of patients with mental health needs, mental capacity assessments and Deprivation of Liberty Safeguards.
- The care and management of patients with mental health needs was not always in line with the Mental Health Act or best practice.
- There had been no action taken on some risks on the risk registers and not all staff had access to the risk register for their service.
- Some improvements had been made to the critical care unit but, there had been no significant progress in improving the environment and clinical audit in critical care.
- The number of medical staff in the end of life care service was insufficient and not in line with national guidance. This was reported in the last inspection.
There were though some areas of outstanding practice:
- The mortuary staff demonstrated a person centred approach to the care of families/friends following bereavement. They were flexible and considerate and embedded the values of the trust.
- The trust organised tea parties and lunches for patients who had been in the trust for a prolonged period. The meals were supported by allied health professionals and volunteers and offered patients an opportunity to socialise away from the ward.
Inspectors also found that staff cared for patients with compassion, treating them with dignity and respect. In most of the services inspected staff maintained patients privacy and dignity and patients, families and carers gave positive feedback about the care being received. Staff involved patients and those close to them in decisions about their care and treatment.
Overall the trust must now:
- Ensure that all patients with mental health needs receive care in line with national best practice that meets the requirements of the Mental Health Act.
- Ensure that all staff are aware of their responsibilities under the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and ensure they are translated into practice. Staff should be able to provide when required evidence that, where appropriate, demonstrates mental capacity assessments and DoLs have been carried out and recorded.
In critical care the trust must:
- Improve the management of medicines to ensure they are stored and disposed of in line with national safety guidance.
- Urgently review fire safety risk and compliance in the HDU and staff areas of the unit. This must include a strategy to ensure fire exits remained accessible at all times.
- Review the storage of equipment in the HDU to ensure staff have safe access to bed bays.
- Implement a strategy to ensure staff follow infection prevention and control standards and compliance is monitored.
- Implement effective record keeping standards for nursing care notes and ensure all information including Deprivation of Liberty Safeguards is recorded.
- Improve the clinical governance and leadership practices in the unit to ensure there is effective peer review and audit; meaningful morbidity and mortality reviews and drives to improve patient outcomes.
England’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“Croydon Health Service NHS Trust continues to require improvement, however we did find some areas of outstanding practice including mortuary staff demonstrating a person centred approach to the care of families and friends following bereavement. They were flexible and considerate and embedded the values of the trust."
“While there have been some improvements in the quality of care since the last inspection, the trust needs to do more to ensure its services are consistently good.”
You can read the report in full on our website.
Ends
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