The Care Quality Commission has taken urgent action to protect children and young people using services provided by East Kent Hospitals University NHS Foundation Trust.
A team of inspectors from the Care Quality Commission visited the Queen Elizabeth The Queen Mother Hospital at Margate and William Harvey Hospital at Ashford in response to information of concern provided by public and staff, and to follow up on the previous findings identified in the emergency department and operating theatres concerning children’s care.
As a result of the inspection in October 2018, children’s services in both hospitals have been rated Inadequate overall. The service was rated Good for caring, Requires Improvement for being effective and responsive and Inadequate for being safe and well led. There has been no change to the trust’s overall rating which remains Requires Improvement.
Following the inspection, CQC used its urgent enforcement powers to impose conditions on the trust’s registration. The conditions applied to the trust’s registration are:
- The trust must not use adult trolleys for patients under the age of 18 unless a risk assessment has been undertaken and documented to minimise any risk of harm.
- The trust must submit a report to the Care Quality Commission each week giving the numbers of paediatric nursing and paediatric medical staff for all shifts along with the number of patients under the age of 18 in both hospitals, along with any incidents reported by the child health division in the seven days prior to the report.
- Every four weeks the trust must submit a report to CQC in respect of the child health division, giving audit figures for pediatric early warning scores, medicines, use of resuscitation trolleys, and sepsis. The reports must show how clinical outcomes are being audited, monitored and acted upon.
- The trust must submit its current risks on the child health division risk register to CQC every two weeks.
- The provider must submit a report to CQC every four weeks on the current training rates for all staff who provide care and treatment to patients under the age of 18.
Since the inspection, the Trust has made significant improvements and CQC should be in a position to remove the conditions in the near future.
Full details of the inspection are available on the CQC website at: https://www.cqc.org.uk/provider/RVV
At the Queen Elizabeth the Queen Mother Hospital inspectors found children’s needs were not always being met because staff were stretched beyond capacity.
Resources to care for patients with mental health concerns were insufficient. At night children were often made to wait in the same emergency department areas as adult patients, sometimes exhibiting volatile behaviours or issues related to alcohol. Inspectors were particularly concerned about reports of a sometimes abrupt and judgemental attitude shown by administrative and senior staff.
At William Harvey Hospital, inspectors had similar concerns over staff availability, poor medicines management and a lack of measures in place to control infections. Patients were waiting too long for treatment.
However, inspectors recognised that despite staff working under pressure they interacted well with babies and children, to keep them distracted and calm. Parents were often complimentary about the care received. In the Special Care Baby Unit at Queen Elizabeth the Queen Mother Hospital, parents reported staff were very caring and supportive.
CQC’s Deputy Chief Inspector of Hospitals Dr Nigel Acheson said:
“It is clear that the children’s services at East Kent Hospitals University NHS Foundation Trust have been working under some pressure, apparently with no end in sight. We could not allow this to continue - and we used our enforcement powers to ensure that appropriate action is taken to protect young patients.
“In general we have seen that the trust has a strong and caring workforce. In particular, the children’s emergency nursing staff were providing excellent, compassionate care although we also found that some staff were overstretched and could be abrupt to parents.
“I am concerned that some of the data that we found had not been properly reported to the board – who through inconsistency in the data were being given false assurance about the quality and safety of care.
“I am pleased to report that since our inspection, the trust has assured us that the service has made significant improvement and we should be in a position to remove the conditions in the near future. We will continue to monitor those services and we will return in due course future to check progress.”
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For further information please contact CQC Regional Engagement Manager John Scott on 07789 875 809 or, for media enquiries, call the press office on 020 7448 9401 during office hours.
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