A team of inspectors has rated the trust as Requires Improvement for safe, responsive and well-led services. The trust was rated Good for providing caring and effective services.
The inspection team visited the Clatterbridge Hospital and Arrowe Park Hospital. Both were rated Requires Improvement. The full reports will be available from Thursday 10 March on the CQC website at: www.cqc.org.uk/provider/RBL.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
"I am pleased to report that our latest inspection found the trust had responded well to our inspection in May 2015. It has made a number of important improvements, not least of which is the increase in the number of nurses, although there is still progress to be made in this area. While the trust continues its improvement journey, it needs to ensure that people using its services receive good quality treatment and care at all times.
“While I am satisfied that the trust is heading in the right direction there is much for it to do to implement its improvement plans and secure more positive outcomes and experiences for patients. The trust has listened to our inspectors’ latest findings and already begun to take action where it is required. We will return in due course to check that the improvements needed have been made and are embedded”.
The team of inspectors and specialists, including doctors, nurses, managers and experts by experience, inspected the hospitals over four days during September 2015 and conducted an unannounced inspection on 24 September 2015.
Inspectors found staff were caring and worked hard to ensure patients were treated with dignity and respect. Staff were positive about working for the trust and the quality of care they provided. The trust had made a positive response to a previous CQC inspection and recruited more nurses to ensure safer staffing levels, but staffing is still a problem in some areas. There were still times when medical wards were not appropriately staffed. This was a concern on Ward 36 at Arrowe Park Hospital and during the night at the Clatterbridge Rehabilitation Centre in Clatterbridge Hospital.
The trust was found to be led and managed by a visible executive team. The senior team was known to staff and it was evident that in response to a disappointing staff survey it had made considerable efforts to engage and include staff in the plans for change and improvement.
Lack of readily available beds in medical wards affected the patient flow within the emergency department. Inspectors found delays in admitting patients to the emergency department within Arrowe Park. This meant that the emergency department was often full and could not immediately treat new patients. The number of ambulances waiting more than thirty minutes over patients had reduced significantly since the introduction of a rapid assessment and treatment area.
The inspection identified a number of areas for improvement, including:
- Ensuring that there are adequate numbers of suitably qualified staff in theatre recovery areas to ensure safe patient care.
- Ensuring the children’s safeguarding training meets Royal College of Paediatrics and Child Health (RCPCH) guidelines 2014.
- Ensuring that robust information is collected and analysed to support improvements in clinical and operational practice.
- Ensuring that risks are always managed and mitigated in a timely way.
The reports highlight several areas of outstanding practice including:
Inspectors observed staff displaying a very caring, person centred attitude which went beyond what was expected. Staff encouraged patients and their relatives to be active partners in their care. Staff went above and beyond to meet patient’s preferences. There were strong relationships between staff, patients and their relatives.
A nutritional risk assessment was in place and consistently used by staff to determine patients’ individual needs. This helped identify patients at risk of malnutrition and helped staff meet existing or changing nutritional and hydration needs.
The sentinel stroke national audit programme (SSNAP) latest audit results rated the trust overall as a grade ‘A’ which was an improvement from the previous audit results when the trust was rated as a grade ‘B’. Since October 2014 the trust had either been ranked first or second regionally in the SSNAP audit.
The Care Quality Commission will present its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.
The reports which CQC publish today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations including Healthwatch.
Ends
David Fryer, CQC Regional Communications Manager on 07901 514220. Mark Humphreys, CQC Regional Communications Officer on 07881656012. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. Please note: the press office is unable to advise members of the public on health or social care matters.
For general enquiries, please call 03000 61 61 61.
Find out more
Read reports from our checks on the standards at Wirral University Teaching Hospital NHS Foundation Trust