Chief Inspector of Hospitals publishes report on the quality of care provided by Ashford and St Peter’s Hospitals NHS Foundation Trust rating the trust as 'Good'

England’s Chief Inspector of Hospitals has rated the services provided by Ashford and St Peter’s Hospitals NHS Foundation Trust as Good overall following a Care Quality Commission inspection in December.

Services were rated as Good for being effective, caring, responsive, and well led, and as Requires Improvement for being safe. Ashford Hospital was rated Good, while St Peter’s Hospital Chertsey was rated as Requires Improvement.

Under its new inspection model, CQC has given individual ratings to each of the core services at the trust’s hospitals; urgent and emergency services (A&E), medical care, surgery, critical care, maternity and gynaecology, services for children and young people, end of life care and outpatients and diagnostic imaging.

The full reports on the trust and on each hospital are available from: www.cqc.org.uk/provider/RTK.

A team of 42 included CQC inspectors and a variety of specialists spent four days at the trust

CQC found that the trust had a new senior leadership team promoting the delivery of good quality care with a clear statement of vision and values. The team was leading by example in focusing on quality and safety while improving the experience of staff working at the trust.

In the accident and emergency department, which was busy throughout the inspection, CQC saw that staff were kind, compassionate and caring. When emergency admissions came into the department, staff were prompt and responsive to people’s needs, while still taking care to be sensitive in explaining what was needed.

Inspectors observed kind, compassionate care being delivered in a respectful way in all services with patients reporting that they were kept informed and involved at all stages of treatment.

Safety and quality of services were a priority for the trust, which was reflected by staff at every level. The trust had a strong reporting culture and was keen to share learning from incidents.

But the inspection found the biggest single safety issue was the impact of staff shortages and the difficulties in recruiting and retaining staff. While the trust used agency, locums and bank staff to help deal with the shortfalls, Safe staffing levels were not being consistently met. Staff indicated to inspectors that the issue with staffing levels was putting them under extra stress and some staff were leaving because of this.

Inspectors identified a number of areas of outstanding practice across the trust:

• The trust had developed an older people’s assessment and liaison team which enhanced the care of the frail, elderly patients. The specialist team’s care had managed to decrease the number of admissions to specialty wards, and also contributed to fewer patients being readmitted. The electronic patient record system in the intensive care unit was outstanding. Patients benefitted from comprehensive, detailed records in one place, where all staff could gain access and update them at all times.
• The trauma and orthopaedic unit had set up an early discharge team to reduce the length of stay for patients with hip fractures. Patients had continuity of care from the hospital in to their own home as they had the same staff. This reduced their length of stay in hospital.
• There was good joint working between the bereavement services, chaplaincy services and the mortuary services to ensure as little distress as possible to bereaved relatives, with caring staff throughout the hospital who were seen to treat patients at the end of their lives and their relatives with dignity and respect.

The trust has been told that it must make improvements in nine areas including:

• The trust must ensure that medicines were stored at temperatures that provide effective treatment.
• All trained paediatric nurses must be up to date with medicines management training.
• Patients’ records must be kept securely and located promptly when required.
• All departments must have sufficient numbers of suitably qualified, skilled and experienced nursing staff on the units and the outreach team to safeguard the health, safety and welfare of patients at all times.
• In the critical care department, there must be a full range of safety, quality and performance data collected, evaluated and reported. The trust must ensure it has sight of this data at board level.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“I am pleased to report that when we inspected the hospitals run by Ashford and St Peters Hospitals NHS Foundation Trust, much of what we saw was good.

“It was clear that staff took great pride in their work, and that they felt the leadership team were approachable. Teams communicated well with each other, and we saw some good examples of collaborative working to improve the treatment and care people received.

“We, also found areas where the trust needs to make improvements - in particular the retention and recruitment of staff in a number of clinical departments. While the trust appears to be maintaining its upward trajectory - it still needs to ensure that people using its services receive good quality treatment and care at all times.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. The trust has told us they have listened to our inspectors’ findings and begun to take action where it is required. We will return in due course to check that the improvements needed have been made.”

Ends

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