The Care Quality Commission (CQC) has published a report following an inspection of medical care and surgery at South Tees Hospitals NHS Foundation Trust in February.
CQC carried out an inspection at The James Cook University Hospital and the Friarage Hospital due to concerns raised by other health and social care organisations. Inspectors looked at the quality of the environment and observed how staff were caring for patients.
Following the inspection, the overall ratings for The James Cook University Hospital and the Friarage Hospital remain as requires improvement. The ratings for medical services and surgery at The James Cook University Hospital went down from good to requires improvement. The rating for medical services at the Friarage Hospital remained as good.
Following this inspection, the trust was issued with a warning notice due to concerns about patient risk assessments, nutrition and hydration and unsafe discharges. The trust took immediate action and has already begun to make improvements.
The overall trust rating remains unchanged and is rated requires improvement.
Sarah Dronsfield, CQC’s head of hospital inspection, said:
“When inspectors visited medical and surgical wards at South Tees Hospitals NHS Foundation Trust, whilst staff worked hard and treated people with kindness, there were areas where improvements were needed to ensure patients are cared for appropriately.
“We observed issues around nutrition and hydration, for example some patients were losing a lot of weight unexpectedly while in hospital, or not being fed properly. There had also been an increase in inappropriate discharge, for example, some patients going home without important medicines or social care packages in place which could put them at risk of harm.
“We also saw patients who required additional support with their meals not being given the help they need. Sometimes meals were left at the end of the bed, and people were unable to reach, and staff didn’t always adjust the beds to a comfortable position so people could eat comfortably and safely.
“We saw on the trust’s own incident reporting system that the frequency and number of incidents where people had come to harm had increased over recent months. Other organisations had also voiced their concerns about these issues prior to the inspection.
“Despite asking the trust for evidence of learning and changes they had made as a result these incidents; we saw the same type of incidents reoccurring. We were therefore not assured that the trust was learning from its incidents and had strong systems in place to ensure that this happened.
“Inspectors reported their findings to the trust leadership who responded promptly and outlined what action they will take to address the patient safety concerns. We will continue to monitor the service to ensure the necessary improvements are made.”
CQC inspectors found:
At the James Cook University Hospital:
- The service did not always have enough staff to care for patients and keep them safe.
- Staff did not consistently assess risks to patients and act on them or keep contemporaneous care records.
- Patients were not always safely discharged from the hospital.
However:
- Staff understood how to protect patients from abuse. The patient’s environments were safe, clean, and well maintained.
- Staff worked well together for the benefit of patients across multi-disciplinary teams.
- Staff treated patients with compassion and kindness.
At the Friarage Hospital:
- The service did not always have enough nursing and support staff to care for patients and keep them safe.
- Medicines were not always well managed.
- Training did not reach the trust’s target.
However:
- Staff worked well together for the benefit of patients and supported people to make decisions about their care.
Full details of the inspection are given in the report published on our website.
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