St Helens and Knowsley Teaching Hospitals NHS Trust is awarded Good rating by Chief Inspector of Hospitals

England’s Chief Inspector of Hospitals has rated St Helens and Knowsley Teaching Hospitals NHS Trust as Good following an inspection by the Care Quality Commission.

The trust has been rated as Outstanding for providing services that are caring, and Good for providing services that are safe, effective responsive and well led. Inspectors rated St Helens Hospital as Outstanding and Whiston Hospital as Good, with Outpatient and Diagnostic Imaging Services at both hospitals rated as Outstanding.

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

“When we inspected St Helens and Knowsley Teaching Hospitals NHS Trust, we found the care and treatment provided to patients was of an extremely high standard across almost all services, with the outpatients departments at both hospitals providing patients with an outstanding service.

"Our assessment of this trust indicates that it is one of the best performing trusts in the country. Members of the senior management team were visible and fully engaged with frontline staff, and the strength of leadership was evident throughout both hospitals sites.

“Staff engagement at this trust is very good and we saw that the trust had a clear vision and set of values that staff understood and worked towards. There was a positive culture throughout. All of the staff we met on this inspection spoke positively about ensuring that patients received a high quality service and experience.

“We have identified a number of areas that require improvement and in particular the maternity service, however, I am confident that St Helens and Knowsley Teaching Hospitals NHS Trust will build on this inspection to ensure that its standards continue to set an example that others can learn from.

“I congratulate the trust, but especially the staff, on this achievement.”

CQC found that the trust had an established and stable senior leadership team that was visible and approachable. Positive patient experience, and the quality and safety of services were the trusts key priorities. Staff across all departments were highly motivated and displayed a clear commitment to providing patients with high quality care and treatment.

Staff treated patients with dignity and respect, and inspectors were told by patients that staff went out of their way to help and support them. Inspectors witnessed exemplary care being given on many wards. In addition, the trust sought feedback from patients and their relatives and used the feedback to continuously improve the care delivered.

The trust had a strong safety culture and the concept of providing safe, harm- free care was considered a priority for staff at all levels. Learning from incidents was widely shared across the trust and staff recognised the importance of reporting incidents to ensure patient safety.

Wards were adequately staffed at the time of the inspection and staff worked flexibly to ensure any shortages were appropriately covered. Where locum doctors or agency staff were used, they received a thorough induction to ensure they were familiar with their working environment. The trust operated a rolling programme of nurse recruitment that meant vacancies were filled in a timely way, however at times the maintenance of nurse staffing levels remained a challenge for managers on some wards.

Care was delivered according to best practice guidelines, and there was strong multidisciplinary team working throughout the trust that supported good patient outcomes.

Inspectors identified a range of areas of outstanding practice, including:

• The trust had developed a pressure ulcer risk assessment tool used by the tissue viability nurses across the wards. This took into account the grade of the risk and a care plan was determined which included the equipment to be used for the patient.
• The ‘additional needs pathway’ ensured a coordinated approach to patients with additional needs which reduced the need for repeat procedures and enhanced the patient’s experience.
• In order to improve the response time and access to timely treatment for a patient, if a critical or abnormal finding on an X-ray was detected, radiology staff could book another follow up appointment with the appropriate specialist at the time of reporting.

Inspectors identified some concerns in maternity services with regards to the access and flow of patients from admission to the delivery suite, staffing and systems to learn from incidents and improve practice - which needed to be better developed. Improvements were also required in the safe storage of medicines on some wards, and in ensuring the privacy and dignity of patients on the coronary care unit. The trust must also continue its efforts to improve waiting times for patients in accident and emergency services.

St Helens and Knowsley Teaching Hospitals NHS Trust provides acute services to a population of 350,000 people across the boroughs of St Helens, Knowsley, Halton and South Liverpool. It serves a wider population for some specialist care including treatment for burns.

The full reports on St Helens Hospital and Whiston Hospital, and the trust overall are available on the CQC website.

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts visited the hospitals in August 2015.

On 14 January 2016, CQC presented 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.

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