Broomfield Hospital

On the 25th of November 2024 we carried out a comprehensive assessment of Children and Young People services at Broomfield Hospital. This was a responsive assessment in relation to potential specific incidents and ongoing concerns over the safety of children and young people receiving care at the hospital. This was the first time the service has been assessed, and it was rated Inadequate overall.

During our assessment we spoke to staff, children, young people and their families using the service. People we spoke to told us staff did their best in a busy service to provide care. People were not always provided with information and at times the support for children and young people was not always tailored to their needs.

Staff did not always have effective support from leaders and skills to deliver safe care. Demands on the service were high, and leaders did not always take timely action to mitigate risk to children and young people using the service. The service was made safer by the good will of staff, often having no breaks and working late. There were systemic cultural issues where staff did not always feel listened to or feel safe to speak up in fear of being targeted or bullied.

As part of our assessment, we requested additional data and information. Some evidence was not provided or available. Due to information gaps we were not assured leaders had good oversight of care delivery and risk management.

Following our assessment the concerns raised demonstrate a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We served a Section 29A Warning Notice for Regulation 17 outlining the breaches and that we required the service to make improvements.

On the 25th of November 2024 we carried out a responsive focused assessment of paediatric emergency department (PED) at Broomfield Hospital. The assessment was prompted in part by notifications of adverse incidents, which are subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this assessment did not examine the circumstances of the incidents. However, the information shared with CQC about the incidents indicated potential concerns about the quality and safety of the service. This assessment examined those concerns. We inspected 6 quality statements across the safe, responsive and well-led key questions. We have not previously rated this service. This assessment did not cover all parts of our assessment framework; therefore, we did not rate the service, and we have only given scores for those areas which we have assessed. We will carry out future assessments to cover other parts of the framework and will update our website with our findings. We found 2 breaches of the legal regulations in relation to safe care and treatment and governance. Our assessment found:

The management of risks to people across their care journey was not always effective. Staff told us that the high level of demand within the department and staffing shortages impacted on their ability to maintain oversight of the patients in the department and to manage risk effectively. There was limited evidence that the service actively sought out, listened to and responded to information about children and young people who were most likely to experience inequality in experience or outcomes. The service did not always have effective governance arrangements in place. Staff did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.

We have asked the provider for an action plan in response to concerns found at this assessment.

On the 25th of November 2024 we carried out a comprehensive assessment of Children and Young People services at Broomfield Hospital. This was a responsive assessment in relation to potential specific incidents and ongoing concerns over the safety of children and young people receiving care at the hospital. This was the first time the service has been assessed, and it was rated Inadequate overall.

During our assessment we spoke to staff, children, young people and their families using the service. People we spoke to told us staff did their best in a busy service to provide care. People were not always provided with information and at times the support for children and young people was not always tailored to their needs.

Staff did not always have effective support from leaders and skills to deliver safe care. Demands on the service were high, and leaders did not always take timely action to mitigate risk to children and young people using the service. The service was made safer by the good will of staff, often having no breaks and working late. There were systemic cultural issues where staff did not always feel listened to or feel safe to speak up in fear of being targeted or bullied.

As part of our assessment, we requested additional data and information. Some evidence was not provided or available. Due to information gaps we were not assured leaders had good oversight of care delivery and risk management.

Following our assessment the concerns raised demonstrate a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We served a Section 29A Warning Notice for Regulation 17 outlining the breaches and that we required the service to make improvements.

On the 25th of November 2024 we carried out a responsive focused assessment of paediatric emergency department (PED) at Broomfield Hospital. The assessment was prompted in part by notifications of adverse incidents, which are subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this assessment did not examine the circumstances of the incidents. However, the information shared with CQC about the incidents indicated potential concerns about the quality and safety of the service. This assessment examined those concerns. We inspected 6 quality statements across the safe, responsive and well-led key questions. We have not previously rated this service. This assessment did not cover all parts of our assessment framework; therefore, we did not rate the service, and we have only given scores for those areas which we have assessed. We will carry out future assessments to cover other parts of the framework and will update our website with our findings. We found 2 breaches of the legal regulations in relation to safe care and treatment and governance. Our assessment found:

The management of risks to people across their care journey was not always effective. Staff told us that the high level of demand within the department and staffing shortages impacted on their ability to maintain oversight of the patients in the department and to manage risk effectively. There was limited evidence that the service actively sought out, listened to and responded to information about children and young people who were most likely to experience inequality in experience or outcomes. The service did not always have effective governance arrangements in place. Staff did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.

We have asked the provider for an action plan in response to concerns found at this assessment.