The Care Quality Commission (CQC) has published a report following an inspection of Russells Hall Hospital, part of The Dudley Group NHS Foundation Trust, in February.
An unannounced focused inspection of the paediatric emergency department was carried out following information of concern received about the safeguarding of children and young people who attended the department.
No ratings were given at this inspection therefore the overall ratings for Russells Hall Hospital and The Dudley Group NHS Foundation Trust remain requires improvement.
Following the inspection, the trust provided a comprehensive action plan with evidence addressing how they would respond or had already responded to the concerns.
Charlotte Rudge, CQC’s deputy director of operations in the midlands, said:
“When we inspected the paediatric emergency department at Russells Hall Hospital, we found some areas that needed improving to ensure children and young people who attend the department receive appropriate care and their needs are met. How staff were implementing safeguarding policies was our biggest concern.
“There was a safeguarding children’s policy in place which explained roles and responsibilities. However, staff didn’t always follow this which could place young people at risk. The understanding of policies and how to follow them was varied with some staff able to articulate how they’d manage concerns and others were unable to give examples.
“This included when a child was known to be vulnerable, there was a lack of awareness in how to assess or treat them while safeguarding them effectively.
“It was concerning that nursing staff shortages resulted in shifts operating without the required staffing levels. While many NHS services and those in the wider care sector also face staffing challenges, the trust must find ways to minimise the risk this poses to people in its care.
“It was positive, however, that leaders were proactive in recruiting new nursing staff and had developed recruitment events as well as inviting prospective staff for tours of the hospital and creating interactive videos for prospective applicants.
“It was also good that the trust was planning an 18-month conversion programme that could be offered to registered nurses wanting to convert to being registered children’s nurses.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made and sustained so children and young people visiting the department receive a good standard of care.”
Inspectors found the following during this inspection:
- Systems were not always effective to ensure service users were protected from abuse and improper treatment
- There was a lack of awareness of the cumulative impact of risk and poor consideration of known safeguarding factors to influence decisions around the child’s care and treatment
- Staff did not actively use national or locally agreed screening tools to aid in the identification of children with additional risks and vulnerabilities
- There was a lack of professional curiosity evident within the records in addition to a lack of curiosity and proactive approach to safeguarding for children where there was known vulnerabilities
- The service did not have enough staff to care for patients and keep them safe or to meet recommended guidelines on staffing. However, the trust was being proactive with addressing this.
However:
- Staff regularly completed multi agency referral forms
- The trust ensured staff received Disclosure and Barring Service checks and had a 100% compliance rate. There was an employment checks policy in place
- A training package for paediatric staff and managing mental health in children’s services was being developed.