The Care Quality Commission (CQC) has published a report on urgent and emergency care provided by University Hospital Aintree, part of Liverpool University Hospitals NHS Foundation Trust, following an inspection in October.
CQC carried out an unannounced focused inspection of the urgent and emergency care department at University Hospital Aintree after receiving information of concern about the safety and quality of care being provided. Also, as part of CQC’s ongoing review of urgent and emergency care services.
During the inspection, inspectors found the department exceeded its maximum planned capacity and some patients were being cared for in the corridor, which remains a national issue for hospital trusts.
The service was not rated following this recent inspection and the previous ratings remain - inadequate overall and for being safe, responsive and well-led. Effective remains rated requires improvement and caring remains rated as good.
Also, following the previous inspection in June 2021, CQC wrote to the trust to impose conditions on their registration in relation to patient access and flow, under Section 31 of the Health and Social Care Act 2008. These conditions require the trust to take urgent action to ensure people are not exposed to further risk of harm, these conditions remain in place.
The overall rating for University Hospital Aintree remains rated requires improvement.
Karen Knapton, CQC head of hospital inspection, said:
“When we inspected urgent and emergency care at University Hospital Aintree, staff were working hard under sustained pressure to deliver care. However, we found people didn’t always receive appropriate care and treatment in a timely way, exposing them to the risk of harm.
“Additionally, staff didn’t always identify and quickly act upon people at risk of deterioration in the waiting room, or complete risk assessments in a timely manner.
“We saw staff treat people with compassion and kindness and took account of their individual needs. Although, they didn’t always respect their privacy and dignity or keep their care confidential, due to people being able to overhear private conversations. This was because of the pressures the trust was facing and lack of space.
“We will continue to work closely with the trust to ensure they make the necessary improvements and will return to check on progress to ensure changes have been made and embedded.”
Inspectors found:
- Patients did not always receive appropriate care and treatment in a timely way, exposing them to the risk of harm. There was a risk that staff did not always recognise or respond appropriately to signs of deteriorating health. Staff did not always complete risk assessments for patients swiftly
- People could not always access the service when they needed it and did not always receive the right care promptly. Waiting times from attendance to treatment and arrangements to admit, treat and discharge patients were not always in line with national standards
- The service did not always have enough nursing staff and support staff to keep patients safe from avoidable harm and to provide the right care and treatment.
However:
- The service had enough medical staff to match the planned numbers
- Staff gave patients enough food and drink to meet their needs and improve their health in all areas of the emergency department except for the waiting room
- Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way.