Huddersfield Royal Infirmary

At our last inspection, we rated this key question requires improvement. At this inspection the rating remains the same. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

We identified breaches of regulation. These included regulation 12 (safe care and treatment) relating to essential skills training and safeguarding training compliance and medicines management (see specific headers for summary). We found a breach of regulation 18 (staffing) relating to safe and effective staffing. We also found a breach of regulation 17 (good governance) relating to the inconsistent upload of patient information onto the electronic patient record.

The service did not always make sure there were enough suitably qualified, skilled and experienced staff to deliver safe care. Senior leaders had taken action to address staffing vacancies through targeted workforce planning and recruitment initiatives. However, sickness continued to impact on daily staffing throughout the service.

Essential skills training and statutory training compliance remained below the trust target range of 90%. However, leaders told us they expected compliance to improve following a more targeted approach, including strengthened oversight through the Well Organised Ward (WOW) initiative. Several modules had been reviewed to determine which required face to face delivery and which could be moved to e-learning.

The service did not always make sure that medicines management and treatments were safe or met people’s needs, capacities and preferences. Clerking of medicines was not always complete and medicines reconciliation rates were low.

We noted inconsistencies in record keeping within the electronic patient record. We found multiple examples across different patient records. Staff documented care in varying and inconsistent areas of the system.