The Care Quality Commission (CQC) has published a report on a service run by the Hillingdon Hospitals NHS Foundation Trust, following an inspection in November.
CQC inspected the trust’s care of older people in its medical wards at the Hillingdon Hospital after people who had used the service relayed concerns about it to CQC.
The inspection found people generally received good care, but there were areas where improvements must be made.
No ratings were issued following this inspection as it was focused on specific concerns.
Ratings for the trust, hospital and service are unchanged following this inspection.
The trust remains requires improvement overall and the Hillingdon Hospital remains rated inadequate. Medical care at the Hillingdon Hospital remains requires improvement.
Nicola Wise, CQC head of hospital inspection, said:
“Many aspects of the care older people using medical care at the Hillingdon Hospital received was meeting standards they have a right to expect.
“Staff had relevant training, including to protect people from risks. They also kept good records and managed medicines well.
“We found staff treated people with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions.
“However, like many other NHS services and others in the wider care sector, the service suffered from not having enough nursing and support staff to care for people and ensure their safety. This meant some people who required one-to-one care weren’t receiving it.
“We also found the service didn’t always manage safety incidents well, or use these as opportunities for learning.
“We reported our findings to the Hillingdon Hospitals NHS Foundation Trust so it can address areas where improvements are needed and build on what’s going well.
“We continue to monitor the service and the wider trust, including through future inspections, to help it provide the safe and high-quality care people have a right to expect.”
The inspection found:
- Staff had training in key skills. They understood how to protect patients from abuse and managed safety well
- The service kept good care records
- Medicines were managed well
- Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it
- Staff treated people with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to people, their families and carers
- The service made it easy for people to give feedback
- Staff felt respected, supported and valued. They were focused on the needs of people receiving care
- Staff were clear about their roles and accountabilities. The service engaged well with people using it and the community to plan and manage services. All staff were committed to improving services continually.
However:
- The service did not always have enough staff to care for patients and keep them safe
- Inspectors observed telephone calls going unanswered
- Staff did not always adhere to the policy to keep medical records secure
- The service did not manage safety incidents well, and CQC saw no evidence of learned lessons learnt from them
- Inspectors were not assured staff communicated effectively with patients with confusion, learning difficulties or hearing impairments.
Following the inspection, CQC told the trust it must take the following steps to ensure it complies with all its legal obligations in the service:
- All governance processes must be robust and reach staff at the front line to improve the quality of the service delivered
- All relevant incidents and learning must be disseminated to all wards to ensure shared learning. This will help prevent silo working.