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CQC takes action at Basildon and Thurrock University Hospitals NHS Foundation Trust after inspection reveals serious concerns

19 November 2012

Rapid and sustainable improvement needed by Essex hospital trust.

The Care Quality Commission (CQC) has issued two warnings demanding immediate improvement at Basildon and Thurrock University Hospitals NHS Foundation Trust.

CQC’s action follows an unannounced inspection at Basildon University Hospital on 3 November that was prompted by a number of serious incidents involving the care of children at the trust.

During the visit to the acute hospital, in Nethermayne, Basildon, Essex, inspectors identified a number of serious concerns.

As a result, and in addition to the warnings, CQC has also told the trust it must commission an independent investigation into the paediatric services provided by the trust.

Both CQC and Monitor, the regulator for Foundation Trusts, will have close contact with the investigation team throughout and will be holding the trust board to account over any decisions made with regard to it improving services.

Andrea Gordon, CQC deputy director of operations (regions), said: “What our inspectors found at the trust on 3 November was completely unacceptable. We have taken this action to assist in driving through improvements which have a positive impact on the people being cared for at the hospital. It is imperative that the trust now ensures it makes changes which are sustainable, embedded and maintained for the future.”

The warnings have been issued in relation to the essential standards, the care and welfare of service users and assessing and monitoring the quality of service provision.

  • Inspectors found, although guidelines meant all children attending the paediatric ward were seen by a nurse within 15 minutes of arrival, staff confirmed some waited more than an hour to see a doctor.
  • Staff said there were often considerable delays in children receiving appropriate medical attention when concerns over their condition deteriorating were escalated to doctors particularly after 5pm and at weekends.
  • Complaints had been made by staff about the lack of senior medical and nursing staff available on the ward and the inadequate skill mix of nursing and medical professionals on the children’s ward, on occasions. Despite this CQC could find no evidence of any effective action having been taken.
  • The trust recently carried out an audit of expired medication at the trust but CQC inspectors still found medicines that should have been discarded during their visit.
  • Inspectors saw reports showing a significant drop in permanent paediatric consultants’ availability in the last few weeks but it was not clear what action had been taken with regard to this.
  • The trust was found to be failing to plan and deliver care to meet the needs of children in a way that ensured their welfare and safety.

It is not the first time CQC has warned the trust. In July this year it was told to make improvements in relation to the same two essential standards, but in relation to inspections of the accident and emergency department and adult wards.

When CQC carried out its follow up inspections, in August and September, improvements had been made.

Andrea Gordon added: "It is highly disappointing that the trust is again in breach of the same two regulations albeit in relation to different parts of the service it offers. That is why we have asked the trust to look deeper at its own processes, policies and procedures by commissioning an investigation.

“We have been working closely with our partner agencies with regard to the trust and our concerns about it. The trust has already given us assurances of what action it intends to take and we will be closely monitoring its progress on the improvements it needs to make.

“Our inspectors will return in the near future and if we find the required progress is not made we won’t hesitate to use our legal powers to protect the people who use this service."

Ends

For further information please contact Louise Grifferty, regional communications manager, on 07717 422917 or the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

Notes to editors

CQC has issued the warning notice to Basildon and Thurrock University Hospitals NHS Foundation Trust in Nethermayne, Basildon, Essex, requiring that action is taken to meet:

  • Regulation 9, care and welfare of service users, and Regulation 10, assessing and monitoring the quality of service provision, Health and Social Care Act (Regulated Activities) Regulations 2010.

Inspectors will carry out a further unannounced visit to assess whether the necessary improvements have been made.

A deadline of 13 January 2013 has been set for improvements to be made.

If improvements are not made, CQC has a range of enforcement powers which include restricting the services that a provider can offer, or, in the most serious cases, suspending or cancelling a service. CQC can also issue financial penalty notices and cautions or prosecute the provider for failing to meet essential standards. Any regulatory decision that CQC takes is open to challenge by a registered person through a variety of internal and external appeal processes.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.