The Care Quality Commission (CQC) has published two reports on services run by The Mid Yorkshire Teaching 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 for the areas of being safe and responsive. Caring remains as good for both sites, the rating for effective has improved to good at Pinderfields and remains good at Dewsbury, and both sites have improved from requires improvement to good for well-led.
Medical care for Dewsbury and District Hospital remains rated as requires improvement overall as well as being safe, effective caring responsive and well-led. Medical care at Pinderfields Hospital also remains requires improvement overall as well as being 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 as requires improvement.
Sheila Grant, CQC deputy director of operations in the north, said:
“Following our inspection of The Mid Yorkshire Teaching NHS Trust it was encouraging to find there were some improvements particularly in the emergency departments and Medical care (including older people's care) however, further work was needed.
“The emergency departments 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 made the assumption that all people would be able to access the technology required and this impeded both departments from being allowed to improve through feedback.
“At both hospitals, some people left the department before undertaking their treatment. However, senior leaders reviewed this information and would call the person to follow up on their condition the following day and if it was needed ask them to come back to the department.
“At previous inspections we highlighted a need for improvements in sepsis management and infection prevention. The pace of improvement around both of these 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
- Peoples 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 in to 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 was good and people were treated with compassion and kindness.