The Care Quality Commission (CQC) has published two reports on services run by University Hospitals of Leicester NHS Trust following an inspection in January.
CQC inspected urgent and emergency care at Leicester Royal Infirmary as part of CQC’s focused winter pressures inspection programme and to check improvements had been made since the last inspection in July 2022, after which CQC issued a warning notice to focus the trust’s attention on safety and ensuring people were treated and admitted in a timely manner.
CQC also inspected maternity services at Leicester Royal Infirmary and Leicester General Hospital to check improvements had been made since the previous inspection in March last year, after which CQC issued a warning notice following concerns regarding people’s safety and staff numbers.
The trust had made improvements since both warning notices were issued.
Following the inspection, the services have been rated as follows:
Urgent and emergency care services at Leicester Royal Infirmary - were again rated as requires improvement overall and for being safe and responsive. Its rating for being well-led improved from requires improvement to good.
Maternity services at Leicester Royal Infirmary and Leicester General Hospital – were again rated as requires improvement overall and for being well-led. The rating for being safe improved from inadequate to requires improvement.
As this was a focused inspection, CQC didn’t rate how effective, caring and responsive the maternity services were. Also, urgent and emergency care services were not rated for being effective and caring on this occasion.
The trust rating has not changed following the inspection and remains rated as requires improvement overall.
Charlotte Rudge, CQC deputy director of operations in the midlands, said:
“When we inspected University Hospitals of Leicester NHS Trust, we found some improvements had been made, although more changes were needed to improve the standard of care people were receiving.
“For example, some people couldn’t always access the urgent and emergency care services when they needed them in a timely way and were waiting too long to be seen and for treatment due to the department being overcrowded.
“However, in maternity services at Leicester General Hospital, some action had been taken to improve the environment’s safety. Access to the unit was now restricted and staff checked the identity of visitors.
“Also, it had implemented a telephone triage system which is a nationally recognised tool to identify people who were at risk of deterioration.
“It’s clear that staff and leaders had worked hard to make some improvements, and leaders know where further changes are necessary. We’ll continue to monitor the trust while those improvements are happening to ensure people receive the safe care they have a right to expect.”
Leicester Royal Infirmary urgent and emergency care services:
- Despite measures to make improvements, some people couldn’t always access the service when they needed it.
- The service wasn’t meeting many of the national standards or metrics around responsive care and treatment. This included people sometimes having to wait on ambulances before going into the department.
- Many medical staff weren’t up to date with their mandatory training, including for safeguarding.
- Risk assessments didn’t always take place in a timely manner.
However:
- Staff had training, experience and competence in key skills, understood how to protect people from abuse, and managed safety well
- The service managed safety incidents well and learned lessons from them
- The service planned care to meet the needs of local people, took account of people’s individual needs, and made it easy for people to give feedback
- Staff were caring and kind. They were focused on the needs of people receiving care.
Leicester Royal Infirmary maternity services:
- There weren’t always enough staff to keep people and babies safe
- Staff didn’t always report all incidents so there were potentially missed opportunities to learn from them
- Although staff kept equipment and the premises visibly clean in most areas, some essential building works had impacted this
- Although there were improvements since the last inspection, there was further development and actions to embed improvements across the service.
However:
- Most staff had training in key skills
- Staff understood how to protect people from abuse and the service worked well with other agencies to do so
- Staff felt respected, supported and valued.
Leicester General Hospital maternity services:
- The service didn’t always have enough staff to keep people and their babies safe
- Staff didn’t always assess and identify risks to people and act on them and didn’t always keep good care records
- Action plans in response to our last inspection were in progress but not all tasks had been completed and reviewed.
However:
- Staff had training in key skills, and generally understood how to protect people from abuse
- Action had been taken to improve maintenance and use of facilities and equipment to keep people safe
- Medicines management had improved to ensure people and babies received their medicines as prescribed and the risk of errors was reduced
- The new leadership team had settled in and there were clear lines of responsibility with a shared plan of action.