Chief Inspector of Hospitals publishes his findings on Airedale NHS Foundation Trust, Keighley

21 November 2013

England's Chief Inspector of Hospitals has published his first report on the quality of care provided by Airedale NHS Foundation Trust at Airedale General Hospital in Yorkshire.

The trust was one of the first to be inspected under radical changes which have been introduced by the Care Quality Commission providing a much more detailed picture of care in hospitals than ever before.

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts spent two days at Airedale General Hospital during September. They examined the care provided in accident and emergency, medical care (including older people’s care), surgery, intensive/critical care, maternity, children’s care, end of life care and outpatients. Inspectors also visited the hospital unannounced on one occasion.

The report which CQC publishes today is based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

Overall the report concludes that patients at Airedale General Hospital were positive about the care they received. Staff said that they felt proud to work at the hospital. There was a good sense of community, with high levels of volunteering.

The trust is well-managed. The trust benefits from a stable, experienced board and a clear governance structure. This is paying dividends in high levels of staff engagement and patient satisfaction.

The inspection team found areas of good practice which included:

• The hospital valued volunteers and they played an important role in helping to run it. For example they helped patients to eat through the Feeding Buddy Scheme, they set up a privacy and dignity room to provide patients with toiletries when they do not have them, and they helped to direct people around the hospital. Volunteers said that their contribution is valued, and they have been given a seat on the Council of Governors.
• The trust has introduced a ‘telehealth’ hub. Telehealth uses electronic information and communication to provide long-distance healthcare and health-relate education. The hub was staffed 24- hours, seven- days- week by nurses who specialise in acute care. A consultant was on hand if required. The hub aimed to provide care to patients with long-term conditions such as respiratory illness. Patients could receive advice and support in their own home, rather than having to go to hospital unnecessarily. The trust also provided this service to prisons across the country.
• The trust had direct access to electronic information held by community services, including GPs. This meant that hospital staff could access up-to-date information about patients, for example details of their current medicine.

CQC has advised the trust where they could improve in the following areas:

The Chief Inspector, Professor Sir Mike Richards, said: "Whenever we inspect we will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

"We found Airedale General Hospital to be well-managed with clinical and managerial teams that deliver positive outcomes for patients and fosters an excellent volunteering ethos.

"We recommend the trust’s volunteering programme as one that others can learn from. The hospital performs above the national average on the new Friends and Family survey (which asks patients whether they would recommend the hospital to others). The feedback we received from patients and the public throughout the inspection was consistent with this.

Is it safe?

"We found that services were generally safe. Staff assessed patients’ needs and provided care to meet those needs. There were procedures in place to keep people safe, for example from infections and from preventable falls. Records were maintained to a good standard in most areas. However, staff shortages in wards for older people meant that patients did not always receive care promptly.

Is it effective?

"Services were delivered effectively and focused on the needs of patients. Outcomes for patients were mostly as expected or better than expected. All key targets were being met or exceeded.

Are services caring?

"The vast majority of people told us about their positive experiences of care. The trust’s patient survey scores match the national averages. Patients said that they were satisfied with how they had been treated, and that doctors, nurses and other staff were caring and professional. Staff respected patients’ dignity and privacy.

Are services responsive to people’s needs? “The services responded to patients’ needs. Overall, patients were treated promptly. Complaints and concerns were handled appropriately.

Are services well-led?

"The hospital was well-led. The trust Board showed a good understanding of key issues. Individual services were also generally well-led. We had some concerns about leadership within the Critical Care Unit."

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

CQC inspectors will return to Airedale District General Hospital in due course to follow up the findings of this inspection and to report on the trust’s progress in making required improvements.

Ends

Notes to editors

The Chief Inspector, Professor Sir Mike Richards, announced in July that he will lead significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. Sir Mike identified 18 NHS trusts representing the variation of care in hospitals in England. These will be the first hospitals to test the new inspection regime.

• Reviewing the nurse staffing levels in wards, particularly those caring for older people, to reflect the dependency of the patients.
• Improving record-keeping, particularly in those areas where staffing levels were not always appropriate.
• Improving staff access to, and uptake of, mandatory training.
• Reviewing the additional duties (such as portering) carried out by staff, particularly healthcare support workers, to avoid compromising patient care.
• Considering how the Critical Care Unit works in step with the rest of the hospital, and review the strategy for the service and the understanding of the standard of service provided.