The Care Quality Commission (CQC) has told Mid and South Essex NHS Foundation Trust it must make urgent improvements after finding deterioration in the quality of medical care across all three of their hospitals at a focused inspection.
The inspection took place in January and February, at the Southend University Hospital, Broomfield Hospital and Basildon University Hospital. This was prompted following concerns received about the safety and quality of the services of medical care and older people’s services. This included people’s nutrition, hydration, pressure area care and the management of risks.
Due to concerns found at this inspection, CQC served the trust with a warning notice. This requires them to make immediate improvements ensuring people using these services are safe. The trust has provided CQC with an action plan outlining how it intends to address the areas of concern outlined in the warning notice.
Following the inspection all three hospitals are now rated as inadequate overall for medical care which is a drop from the previous rating of requires improvement. They are also rated inadequate for being safe, effective and well-led. Responsive and caring were inspected but not rated at this time.
This inspection of medical care has affected the overall rating of both Basildon Hospital and Broomfield Hospital, which have now dropped from requires improvement to inadequate as have their ratings for safe, effective and well-led.
Southend Hospital remains rated as requires improvement.
Mid and South Essex NHS Foundation Trust remains rated as requires improvement overall.
Hazel Roberts, CQC deputy director in the east of England, said:
“Following our inspection of medical care at the Mid and South Essex NHS Foundation Trust we found a leadership team who didn’t have complete oversight of the issues they're facing.
“We've highlighted a number of issues where they need to have far better oversight and where we want to see significant improvements. This includes making sure people are able to access the service when they need it, and that there are enough, trained staff to care for them safely.
“Leaders need to ensure they are allowing staff the time to complete essential training, including safeguarding and conflict resolution. This helps staff to understand and look out for risks and how to deal with them. Without this training, staff weren’t always able to complete and update risk assessments for each person to remove or minimise these risks.
“It was also disappointing that people’s privacy and dignity wasn’t always respected. We found areas in all three hospitals where a ward at full capacity didn’t have curtains or screens to provide privacy and dignity to every person occupying a bed.
“During the inspection we did see staff mostly treating people kindly and with care. However, we also saw in some areas, staff didn’t always support people to make informed decisions about their care and treatment. Especially when the person lacked capacity to make their own decisions or was experiencing a severe mental health crisis.
“We are aware the local integrated care system is supporting the trust, as are NHS England and they should use this additional expertise and resource to make the rapid improvements that we need to see. Leaders also need to listen to staff who are in the best position to help implement the changes needed to ensure these improvements are embedded.
“we have fed back our findings to the trust leadership team who were fully aware of what they need to do to make and embed the improvements needed. We will re-inspect to ensure improvements are being made and won’t hesitate to take further action if needed to protect people.”
Findings from all three locations included:
- The premises and equipment along with the upkeep did not always keep people safe
- The service did not always have enough nursing and support staff
- People’s dignity and privacy was not always respected by staff
- People could not access the service when they needed it
- Waiting times from referral to treatment and arrangements to admit and treat people did not always meet national standards
- People were not always safe because staff did not always complete and update risk assessments for each person to remove or minimise risk
- Staff did not always keep detailed records of people’s care and treatment.
However,
- People were treated with compassion and kindness
- People’s individual needs were supported, and staff helped them understand their conditions. Staff also provided emotional support to people and their loved ones.