The Care Quality Commission (CQC) has published a report following an unannounced inspection of urgent and emergency services at Whiston Hospital, run by Mersey and West Lancashire Teaching Hospitals NHS Trust, in March.
Inspectors visited the urgent and emergency services due to concerns CQC had received about the access and flow around the department and people being cared for in non-clinical areas. Inspectors found that while there were problems, senior leaders where aware and were managing the risks to people.
As this was a focused inspection, the service was not re-rated and the previous rating of requires improvement remains in place for the service overall, as well as for being safe and responsive. Effective, caring and well-led remain rated as good.
The overall rating for Mersey and West Lancashire Teaching Hospitals NHS Trust remains outstanding and Whiston Hospital remains rated as good.
Inspectors found:
- The service did not always have enough nursing staff, some areas had one nurse caring for eight people instead of the recommended one to four ratio.
- There were frequent delays in ambulance handovers, and triage was at full capacity. This meant people had long waits and were often cared for in non-clinical areas.
- Risk assessments were carried out quickly and care plans were reviewed and updated to reflect people’s choices. However, staff said it was difficult to complete all risk assessments required due to staffing and time constraints.
- Some external partners raised concerns about access and flow through the department which resulted in delays in ambulance handovers. But they also said senior leaders had good oversight of risks and engaged in quality improvement projects.
However:
- Leaders had put in place processes to manage the risks of care in non-clinical areas and efforts had been made to ensure that these areas were safe.
- Safety was a priority for everyone, safety incidents and concerns were managed well, and lessons learned. The department was clean and well maintained.
- The investigation of incidents demonstrated a good level of involvement from people and their families. They were given the opportunity to ask questions as part of the investigation and received copies of the final report.
The report will be published on CQC’s website in the next few days.
