The Care Quality Commission (CQC) has published a report on two services run by The Mid Yorkshire Hospitals NHS Trust following an inspection in September.
CQC carried out a focused inspection of the urgent and emergency care departments at Pinderfields Hospital and Dewsbury and District Hospital as part of CQC’s ongoing review of urgent and emergency care services. Medical care (including older people's care) was also inspected at both sites.
Pinderfields Hospital and Dewsbury and District Hospital both remain requires improvement overall as well as being for safe and responsive. Caring, effect and well-led remain as good.
Medical care for Dewsbury and District Hospital remains rated as requires improvement overall as well as being for safe, effective caring, responsive and well-led. Pinderfields Hospital also remains requires improvement overall as well as being for safe, effective and well-led. Caring remains rated as good and responsive jumped from requires improvement to good.
In both sites urgent and emergency care remains rated as requires improvement as are the ratings for safe and responsive. Dewsbury and District Hospital remains rated as good for being as effective and caring. Well-led has improved from requires improvement to good. Pinderfields Hospital was rated as good for being caring. Well-led and effective have both improved from requires improvement to good.
The overall rating for the trust, remains requires improvement.
Sheila Grant, CQC deputy director of operations in the north, said:
“Following our inspection of The Mid Yorkshire Hospitals NHS Trust it was encouraging to find there were some improvements particularly in the emergency departments and medicines however, further work was needed.
“At Dewsbury and District Hospital, we found receptionists not medical staff, would regularly use their judgement and guidance to direct patients to the most appropriate area. None of the reception staff had received additional training. We weren’t assured that leaders had a good oversight of this process.
“The emergency departments also planned care to meet the needs of local people. However, if a person didn’t have English as a first language it wasn’t always easy to give feedback on care. Additional languages were available through a displayed internet link, but the displayed information was only in English. This assumed all patients would be able to access the technology required and this impeded both departments from being allowed to improve through patient feedback.
“However, at both hospitals, some people left the department before undertaking their treatment.
“At previous inspections we highlighted a need for improvements in sepsis management and infection prevention. The pace of improvement around both areas gave us enough assurances that the service had improved their management of risks to ensure people were being kept safe.
“We reported our findings to the trust who know what they must do to ensure further improvements are forthcoming. We will continue to monitor the trust closely and will return to carry out another inspection to ensure any further improvements are sustained and embedded.
In both hospitals inspectors found:
In urgent and emergency services
- People’s risk wasn’t always assessed by staff in a timely manner
- Facilities for people with mental ill health didn’t meet national standards
- People could access the service but would have to wait for assessment and treatment.
In medical care
- There weren’t always enough staff on duty to keep people safe
- People were sometimes at risk of deterioration because staff didn’t always respond quickly enough
- The service didn’t always control infection risk well
- The environment didn’t always meet the needs of people
- Staff didn’t always manage medicines well
- The service didn’t always ensure that people made decisions based on all the information available
- People’s communication requirements weren’t always taken into account
- Improvement actions weren’t always delivered in a timely way
- Risk wasn’t always managed well by leaders.
However, inspectors also found:
In urgent and emergency services
- People were treated with compassion and kindness. Staff respected their privacy and dignity and took account of their individual needs
- There were enough staff to care for peoples and keep them safe
- Safety incidents were managed well and lessons were learned from them to ensure people were kept safe.
In medical care
- Staff know how to protect people from abuse
- People had enough to eat and drink and were given pain relief when they needed it
- Emotional support to people, families, and carers by staff, People were treated with compassion and kindness.