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Provider: The Dudley Group NHS Foundation Trust Requires improvement

Reports


Inspection carried out on 26 and 27 March 2014

During a routine inspection

We carried out this comprehensive inspection as part of the new hospital inspection programme and as a follow up to the Keogh review which took place in 2013. Of the 14 trusts inspected under the Keogh review for the quality and safety of their services, The Dudley Group NHS Foundation Trust was one of only three trusts that were not put into special measures. That review identified concerns regarding:

  • governance arrangements
  • the need to embed a culture of learning from incidents
  • how the trust uses and reviews mortality data
  • the system for bed management and patient flows
  • embedding patient experience in the organisation’s learning and strategy
  • staffing levels and skills mix
  • safety and equipment checks
  • pressure ulcer care.

Before the inspection conducted in March 2014, the Trust was identified in CQC’s intelligent monitoring system as a priority band 4 Trust. There are six bands within the monitoring system so this Trust had a relatively lower risk.

We noted that the trust’s action plan to address the concerns following the Keogh review had been put into place and signed off.

Our inspection of The Dudley Group NHS Foundation Trust included Russells Hall Hospital, Corbett Outpatient Centre and Dudley Guest Outpatient Centre.

The announced inspection took place between 26 and 27 March 2014, and unannounced inspection visits took place in the two weeks following this visit.

Overall, this trust was found to require improvement, although we rated it good in terms of having caring staff, and effective services.

We saw much support for the trust, both from the public and from the local health economy.

We saw a trust that was a considerable way along its improvement journey and saw many areas of strong development. Whilst some of the core service areas within the trust required improvements in leadership, we found the executive team and the trust board had a clear focus on improvement and as such we rated this trust as good for its overall leadership.

The improvements required by the trust were within the grasp of the trust and its leaders. We were confident that these could be achieved quickly.Key findings related to the following:

  • The trust’s staff are seen as highly caring by many of the patients we spoke to and praised the staff for ‘going the extra mile’.
  • The trust’s leadership team is seen as highly effective by the staff; and is recognised to be clearly in touch with the experience of patients and the work of the staff.
  • Staff value the Dudley Group as a place to work and a team spirit is clearly evident.
  • The trust has responded well to the Keogh review in 2013.
  • There are a number of areas of good practice in the trust, which should be encouraged. Staff feel able to develop their own ideas and have confidence that the trust will support them.
  • The emergency department (A&E) is busy and overstretched. There remain challenges in the flow of patients, but much of this relates to flow across the rest of the hospital. Only a small proportion relates to the emergency department itself.
  • The trust does not always follow its own policy in relation to DNACPR (do not attempt resuscitation) notices.
  • The ophthalmology clinics require review to ensure that all patients are followed up as required and that there is capacity for these clinics.
  • The trust must review its capacity in phlebotomy clinics as this is seen as insufficient.

Professor Sir Mike Richards

Chief Inspector of Hospitals


CQC inspections of services

CQC Insight

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Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect.


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Organisation Review of Compliance

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Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.

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