- NHS hospital
St Peter's Hospital
Report from 5 March 2024 assessment
Contents
Ratings - Medical care (Including older people's care)
Our view of the service
We conducted a responsive, focussed assessment of the medical division at St Peter’s Hospital commencing on 20 March 2024, due to receiving information of concern related to the delivery of patient care. We assessed a limited number of quality statements from all 5 key questions and found areas of good practice and some concerns. The care we observed was safe and patients were positive about their experiences. However, we found breaches of the regulations for safe care and treatment. Planned versus actual nursing staffing did not always match, due to short notice sickness absence. Patient records showed unwitnessed falls and medicine errors that could be attributed to low nurse staffing and skill mix, along with reported lapses in personal care such as nutrition and promoting mobility. There was a delay in informing the trust of the breaches and we have asked the trust for an action plan.While the division had established governance processes appropriate for their service, staff expressed concerns of a lack of an open safety culture within the trust and told us safety was not always a top priority. There was a new executive leadership team in place at the time of our visit. Some staff said they did not feel confident to raise concerns and felt this was adversely affecting the work of the division. A number of senior staff expressed worry about a lack of a clear vision and organisational strategy to guide priorities. Senior trust leadership had recognised these problems, and the trust chairperson had asked for an independent review shortly before our assessment visit. We saw evidence of initial actions undertaken by the executive team in response to the report recommendations. The scores for our assessment have been combined with scores based on the key question ratings from the last inspection. Though the assessment of these quality statements indicated some areas of concern, our overall rating remains good. Our assessment was significantly delayed due to technical and other issues related to changes within the CQC. We acknowledge that during this time planned interventions and improvements in governance was progressed by the trust.
People's experience of this service
People in the wards we visited were positive about the quality of their care and treatment. For example, one person told us “The care is first class, they’re quick to respond if I’m in pain but they are very short staffed - they are having to work very hard.” Others also acknowledged the pressure staff were under and during the assessment process we reviewed complaints and incident reports which indicated trends of poor patient experience associated with low staffing, inadequate communication with patients and relatives and delayed treatments.