North Tees and Hartlepool NHS Foundation Trust is rated by the Care Quality Commission following comprehensive inspection

England's Chief Inspector of Hospitals has told North Tees and Hartlepool NHS Foundation Trust that it must make improvements following an inspection by the Care Quality Commission.

North Tees and Hartlepool NHS Foundation Trust was rated as Requires Improvement overall. The trust was rated as Good for whether its services were safe, caring and responsive and rated as Requires Improvement for whether its services were effective and well-led.

Both University Hospital of North Tees and University Hospital Hartlepool were rated as Requires Improvement overall, but the trust’s community services and services provided at the One Life Centre Minor Injuries Unit both received an overall rating of Good.

Full reports including ratings for all the trust’s care services is available on this website.

In addition to the two hospitals, North Tees and Hartlepool NHS Foundation Trust provides a range of community health services for a population of approximately 400,000 people across Hartlepool, Stockton-On-Tees and parts of County Durham.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“Our inspectors found some areas of good and outstanding practice across North Tees and Hartlepool NHS Foundation Trust, with staff going the extra mile to improve the support that they provided to people.

“We found that the trust had a clear strategy in place, focussed on integrating services and delivering care for patients closer to home.

“However, we also saw services where more needed to be done to make sure that care and treatment consistently met the required standard.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs.

“Since our inspection we have been working closely with Monitor and other stakeholders, such as the local Clinical Commissioning Group and NHS England.

“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”

Inspectors found that staff were caring and compassionate, and treated people with dignity and respect.

Across both the acute hospital and community services, arrangements were in place to manage and monitor the prevention and control of infection and all areas visited were clean. However, in the accident and emergency department inspectors found that infection control procedures were not always followed.

Staff reported that there was a strong culture of learning and improvement, and training and development was actively encouraged. Care was delivered according to best practice guidelines, and there was strong multidisciplinary team working throughout the trust.

However, inspectors raised concerns about staffing shortages on some wards and there was a reliance on bank and agency staff to maintain safe staffing levels.

Inspectors identified concerns with medicines management across the trust, in particular on the Holdforth Unit, which provides rehabilitation to patients who need support prior to returning home. Records were not always being signed by staff to show when medicines had been administered. On some wards, inspectors found that medicines were not always being stored at the correct temperature.

Across the trust, the inspection team found several areas that needed to improve:

• The trust must ensure there are always enough suitably qualified staff to deliver safe care in a timely manner.
• The trust must ensure that staff follow trust policies and procedures for managing medicines, including controlled drugs and ensure that medicines are stored according to storage requirements to maintain their efficacy in maternity services.
• Risk assessments must be documented along with personal care and support needs and evidence that a capacity assessment has been carried out where required.
• The trust must ensure effective systems are in place to enable staff to assess, monitor and mitigate risks relating to the health, safety and welfare of people who use the service.
• The trust must ensure that infection control procedures are followed in relation to hand hygiene and use of personal protective equipment.
• Resuscitation and emergency equipment must be checked on a daily basis in line with trust guidelines.

Inspectors also witnessed several areas of good and outstanding practice across the trust, including:

• The development of advanced nurse practitioners which had enabled the hospital to respond to patient needs appropriately and mitigate the difficulties in recruiting junior doctors.
• A training suite had been set up to simulate procedures within surgery and enabled staff to practice and develop their skills in a safe environment.
• The critical care team’s approach to tissue and organ donation was impressive, demonstrating a compassionate and sensitive approach to patients and relatives.
• The trust was working in conjunction with Hartlepool Council to improve healthcare for people with learning disabilities. When a patient with learning disabilities was admitted to the hospital, a specialist nurse would be notified to ensure that the trust was able to respond to their needs in an appropriate manner.

CQC’s inspection team informed the trust of its findings immediately after the inspection so that it could take steps to make any improvements.

A team of CQC inspectors and specialists including doctors, nurses, managers and experts by experience spent four days at the trust in July 2015.

Under its inspection model, CQC has given individual ratings to each of the core services at the trust; urgent and emergency services, medical care, surgery, critical care, maternity, services for children and young people, end of life care and outpatients and diagnostic imaging. Community services were also given overall ratings.

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