Archived: Ealing Hospital NHS Trust

We visited at least twelve wards and departments, including the Accident and Emergency departments for children and adults, maternity services, wards for elderly people, the Older Persons Rapid Assessment Clinic and other surgical / medical wards. We spoke with people using the service, families or carers and staff in every area we visited. We also spoke with senior management staff including the Deputy Director of governance, the Deputy Director for Nursing and Director of Human Resources.

All the people we spoke with told us they were very satisfied with the service they received and they praised the caring, helpful and professional attitude of staff. People told us they had been treated with dignity, respect and had been involved in their treatment.

The trust had many arrangements in place to ensure people received safe and appropriate care. People's needs were assessed and care and treatment was planned according to their identified needs. There was a range of risk assessments to assess and minimise risks people might face and their condition was appropriately monitored to ensure their safety and welfare. However, we found that an arrangement in place to prevent a serious incident from happening had not been effective to ensure people were protected from the risks of poor and unsafe care and treatment.

There were systems in place to manage the discharges of people so these took place as safely as possible and for people to have the necessary support and care while they recuperated in their own homes.

Staff were aware of the action to take to deal with allegations or suspicions of abuse by reporting the matters to their managers or to the local authority. Where these were raised the trust took appropriate action to safeguard people. However,the trust did not have adequate arrangements in place to enable and to facilitate staff to raise concerns and make disclosures in the public interests.

The trust employed staff in sufficient numbers and provided adequate training and support to ensure people's needs were being met appropriately.

The trust had a complaints procedure and complaints were classified as formal complaints and 'concerns' (informal complaints). We found that once formal complaints were received, these were appropriately dealt with and responded to. Required action plans were drawn up to address areas where improvements were needed. However, the complaints procedure was not always brought to the attention of people and their representatives in a suitable manner and format so they were fully aware of how to make a complaint. There was also a lack of information about advocacy services to support people in making complaints. We noted that there was a lack of clarity in regards to defining formal complaints and 'concerns' raised by people and the recording of 'concerns'. This meant that the complaints system was not effective to ensure that all complaints were identified, received, handled and responded to appropriately.

The inspection was carried out as part of a CQC pilot inspection project of NHS community based services. For this pilot we tested different ways of seeking feedback and information about the service from the provider and people who use the service. The visits to these services took place over three days, with a fourth day to visit the trust headquarters to provide feedback of our findings.

We visited a number of children services, including health visiting, school nursing, children's community nursing, child development services, immunisation clinics, physiotherapy, speech and language and occupational therapists. We also carried out an inspection of Ealing Services for Children with Additional Needs (ESCAN).

We spoke with twenty five parents of children who received care, treatment or support from the service and forty members of staff. Without exception all parents told us that they were very happy with the treatment they received. They said they felt listened to and involved in the treatment plans for their child. People said they were treated with respect and given advice and information in relation to looking after their children.

People's needs were assessed and care plans developed that ensured people's needs were met effectively. Risks to people's welfare were assessed and plans were put in place to minimise these.

The trust had appropriate systems in place for safeguarding children. Staff we spoke with were clear about their accountability and responsibilities in safeguarding children. They also received training and were supported in their jobs to ensure they provided the necessary standard of care and treatment to people safely and effectively.