Care Quality Commission (CQC) inspectors have found a number of improvements at Kettering General Hospital NHS Foundation Trust but say more work is needed to ensure people receive the standard of care they should be able to expect.
Inspectors visited the trust unannounced on 14 and 15 June 2017 to check whether improvements had been made following its previous inspection in October 2016. Subsequent announced visits also took place on 22 and 28 June when inspectors met with the leadership team.
Progress had taken place in the areas inspected and the requirements of the warning notice we had issued in November 2016 had been met. The leaders of the trust and in the core services inspectors visited had made significant progress to improve and address concerns raised at the last inspection.
There was a clear focus on patient safety, effective risk assessment and management throughout the areas visited, which was demonstrated by all staff.
Trust managers now have an effective oversight of the hospital’s referral to treatment (RTT) performance and could clearly show how the recording system worked and how many patients were waiting to be seen.
Parents and children were extremely positive about the care and treatment they received regarding inpatient and outpatient services at the hospital.
However, more work is needed to ensure sure that patients receive the best possible care across all wards and departments. The trust remains in Special Measures with an overall rating of Inadequate.
Full reports are available on our website.
CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“Our inspectors found a number of improvements had been made at Kettering General Hospital NHS Foundation Trust since our last inspection, and staff are to be commended for this."
“We noted a positive change in culture among staff and leaders at the trust. Staff felt that communication from the trust wide team down to ward staff had improved."
“Patients arriving by ambulance or self-presenting to emergency department reception now received a timely initial time to clinical assessment."
“Previous concerns surrounding the number of patients waiting over 52 weeks for their treatment on the admitted and non-admitted referral to treatment pathways had improved. This had reduced from 413 to 182 patients waiting."
“As this was a focused inspection, we looked at the main areas of concern detailed in the warning notice that we had previously issued. We did not inspect all areas so therefore no core service was rated and the October 2016 inspection ratings remain in place."
“The trust still has some way to go on its improvement journey. There were a number of areas where action was still needed, particularly with regard to the continuing the improvement in delays in triaging patients in A&E as well as monitoring concerns surrounding protocols in Skylark ward with the community and mental health service."
“We have made it clear where we expect to see further improvement and the trust knows what it must do to address the issues we have highlighted. We will continue to monitor Kettering General Hospital NHS Foundation Trust and will return to check on its progress.”
Inspectors found many areas of improved practice, including:
- Effective risk management processes were now in place, embedded and monitored in the areas visited.
- There was oversight on the potential deterioration of patients waiting over 18 weeks for treatment. Staff communicated with patient’s GPs to find out about potential harm.
- Staff training in paediatric competencies had significantly improved since the last inspection. Training compliance had improved since the recruitment of a practice development nurse, who was now monitoring compliance and performance in this area.
- Staff showed care and compassion towards patients and their families. Patients told us they had been treated with kindness, dignity, and respect.
- There were clear systems in place to safeguard vulnerable children in the emergency department. The safeguarding policy now reflected national guidance.
- The trust’s clinical harm review had been recognised as an ‘exemplar’ process and arranged for the trust’s process to be presented at the national elective care conference.
The trust should improve in some areas, including:
- The trust should review processes so that 95% of all patients that self-present and arrive by ambulance to A&E receive an initial clinical assessment within 15 minutes.
- The board assurance framework had not significantly changed since the October 2016 inspection. It remained a complex document that lacked clear links with the corporate risk register.
- The computer system in the emergency department used for triaging patients and capturing data needing improving, so that the first set of clinical observations could be recorded.
- Children and young people with mental health issues who exhibited violent and aggressive behaviours were sometimes inappropriately placed on Skylark ward, as there were no other appropriate placements available in the community. This posed a pressure to staff and for care of patients on the ward. This was reflective of system-wide pressures across the health economy.
Ends
For further information, please contact Regional Engagement Officer, Helen Gildersleeve, on 0191 233 3379.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.