CQC inspectors have found improvements at Sheffield Teaching Hospitals NHS Foundation Trust, but more needs to be done to ensure services are safe, following an inspection in September.
CQC carried out the inspection to check if improvements had made since the last inspection.
Inspectors visited the following areas across the trust; medical wards (including services for older people) and surgery at the Royal Hallamshire Hospital and Northern General Hospital, urgent and emergency care at Northern General Hospital and maternity services at the Jessop Wing.
Following the inspection, the trust’s overall rating remains as requires improvement. Safe has moved up from inadequate to requires improvement, effective and caring have moved up from requires improvement to good, and responsive and well led remain as requires improvement.
Sarah Dronsfield, CQC head of hospital inspection, said:
“When we returned to Sheffield Teaching Hospitals NHS Foundation Trust, it was promising to see that several improvements had been made and we hope the trust continues to make progress across services to ensure people receive safe and appropriate care.
“We were pleased to see significant improvement regarding how staff assessed and managed the risk to patients including those presenting with the risks a deterioration of physical or mental health.
“In maternity services, CQC previously identified that there were difficulties requesting additional assistance when women deteriorated. During this inspection we saw a specific emergency bleep number had been created for staff to respond to deteriorating women, which had improved response times and intervention.
“In urgent and emergency services, people’s observations were undertaken in a timely manner and we observed good multidisciplinary team communication.
“The trust had also worked hard to improve culture and most staff told us they felt respected, supported, and valued. Leaders had improved systems to identify and manage risk, issues and performance.
“Throughout our inspection we saw staff treating patients with compassion and kindness and delivered care which respected people’s individual needs.
“It’s promising that trust leaders and staff have begun to make improvements which have improved patients experience of care at the trust. We will continue to monitor the trust and expect to see the improvements have been sustained and embedded, and that the trust has addressed the areas where further improvement is still needed, by the next time we inspect.”
Inspectors found the following during this inspection:
- The trust had not trained enough numbers of staff to ensure physical restraint was undertaken safely and appropriately
- In surgery and medicine, the trust had not identified and addressed environmental risks including risks presented through unsafe storage of equipment, cleaning supplies and medical gases
- People could not always access services when they needed it or receive the right care promptly
- The trust had not made significant improvement in identifying and reporting serious incidents. There remained a backlog of serious incidents requiring investigation
- In surgery, the trust had continued to experience never events and had not implemented a consistent approach to ensure staff learn and share lessons learnt from these incidents
- In medical services, patients subject to the Deprivation of Liberty Safeguards did not always have a recorded capacity assessment or decision recorded in their best interest
- Staff did not consistently undertake and record the required physical health monitoring after administering rapid tranquilisation to keep patients safe.
However:
- Most services had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment
- Staff assessed and managed the risk to patients including the risks presenting due to deterioration in patients’ physical or mental health
- The trust had implemented new and regular audits and reviews to ensure care met fundamental standards
- Leaders had reviewed and improved governance systems and oversight of risk, issues and performance in frontline services
- Staff supported and involved patients, families, and carers to understand their conditions.