The Care Quality Commission (CQC) has published a report following an inspection at University Hospitals of Leicester NHS Trust.
CQC carried out an inspection of surgery services in June at Glenfield Hospital due to concerns around waiting times for elective surgery and cancer. Inspectors also looked at how well led the trust was overall in September.
Following this inspection, the rating for the trust overall, as well as for being responsive and well-led has declined from good to requires improvement. Being safe remains rated as requires improvement and caring and effective remain rated as good.
Glenfield Hospital remains rated requires improvement overall and for being safe, effective and well led. How responsive the hospital is has declined from good to requires improvement and caring remains rated as good.
Sarah Dunnett, CQC head of hospital inspections, said:
“During our inspection at University Hospitals of Leicester NHS Trust, there had been several recent changes in the leadership team. Staff felt the new team were already having a positive impact on the organisation and they were visible and approachable for patients and staff. Although some action had been taken to improve the culture, not all cultural issues had been fully addressed yet.
“The new leadership team need to take urgent action to reduce the significant referral to treatment delays for people waiting for elective surgery. People need to be seen much faster, to increase the chance of better outcomes. Leaders are aware of the problem and are looking at how to address these delays as a priority.
“At Glenfield Hospital, many wards didn’t have enough nursing staff to be able to spend time with their patients and meet their individual needs. There was a high reliance on bank and agency nurses who didn’t always have time to get to know the patients. Although, there was enough staff to keep patients safe.
“We found staff treated patients with compassion and kindness. They also helped patients understand their conditions and provided emotional support to them, their families and carers.
“Leaders know what improvements are needed, especially around waiting times and the culture throughout the organisation. We hope the trust makes rapid improvements and we will return to check on progress.”
With regards to well-led, inspectors found:
- The trust’s 2018 vision and strategy did not accurately reflect current priorities.
- Not all staff, including those with protected characteristics under the Equality Act, felt they were treated equitably.
- The trust had prioritised making the board and overall leadership team more effective, particularly since the chief executive started in October 2021.
- The trust’s current governance arrangements resulted in duplication which meant there was duplication in the flow of information through to the executive boards and board committees.
However:
- The trust now had clear plans and timeframes to implement a new strategy.
- Leaders had the skills and abilities to run the trust with relevant experience and capability to deliver sustainable care.
- The whole trust senior leadership team was more diverse than during our last inspection in 2019.
- The emphasis on the safety and wellbeing of staff within the trust was improving.
- All staff were committed to continually learning and improving services.
At Glenfield Hospital, inspectors found:
- There were medical devices that were past their next service date and staff were not checking this before use.
- Staff did not always appropriately monitor room temperatures and take necessary action if medicines had not been stored correctly.
- Several patients who spent a long time in hospital complained that there were no entertainment facilities in their rooms.
However:
- Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
- Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
- Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.
- The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.
- Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it.