England’s Chief Inspector of Hospitals has rated The Rotherham NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission.
Inspectors found that the trust provided services that were caring, but that the trust required improvement for providing safe, effective, responsive and well led care.
The team of inspectors and specialists including doctors, nurses, managers and experts by experience visited Rotherham Hospital and community healthcare services provided by the trust over four days during February 2015. A further unannounced inspection of Rotherham Hospital took place in March 2015. Full reports including ratings for all of the provider’s core services are available.
A separate Review of health services for Children Looked After and Safeguarding in Rotherham was conducted simultaneously. The report from that review is also published today.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“It is clear that The Rotherham NHS Foundation Trust has a number of issues it has to address.
“Across the trust we saw many examples that showed that staff were caring, compassionate and treated patients with dignity and respect, even when they were working under significant pressure. Planned staffing levels were not being achieved on many wards and this was affecting staff morale and staff retention rates.
“We found safety within community services for children, young people and families to be Inadequate. The trust was making progress towards increasing the numbers of health visitors and school nurses, but staff felt their caseloads were unmanageable. Inspectors raised concern that information was not always effectively shared between teams regarding children who may be at risk. Our inspectors have reported their findings separately in a further report.
“The trust has acknowledged the importance of the challenges it faces and I believe that it has the potential to improve services. We will return in due course to check that all the improvements we have identified have been made. While there are a number of challenges ahead, the executive team displayed a proactive approach during the inspection and took immediate action to address some of the issues we identified.”
“In the interim the trust must make sure that robust systems are in place to ensure that incidents are reported and that feedback is provided back to staff. The trust must also ensure that the cross organisational learning from incidents, and complaint investigations is implemented and monitored to prevent recurrence and secure service improvements for patients.”
Inspectors found that services were provided by dedicated, caring staff and that patients were treated with dignity and respect. The majority of patients spoke positively about the care and treatment that they received and inspectors saw that patients and their families were involved in decision making regarding their care.
However, inspectors raised concerns about staffing levels across a number of services. There was a heavy reliance on bank and agency staff to maintain safe staffing levels. Although the trust was actively recruiting nurses, this remained a challenge. Not all staff working in the community felt fully engaged although steps were taken by the trust to initiate improvements to this situation.
The systems in place to manage risk were not universally robust. In some services, staff were not always reporting incidents which meant that senior managers did not have an accurate picture of the risks across the organisation as a whole.
Some wards at Rotherham Hospital did not meet national guidance on same sex accommodation which requires segregated facilities for men and women. The trust has subsequently taken action to address this issue.
The inspection found a number of areas for improvement, including:
- All staff must receive appropriate training and development so that they are able to assess the capacity and best interests of patients in line with the Mental Capacity Act 2005 and deprivation of liberty safeguards.
- There must be sufficient numbers of appropriately- skilled staff on duty to meet the needs of all patients.
- Incidents must be reported and investigated in a timely manner, with learning shared with all staff.
- Children and young people using the short break service must be protected against the risks associated with the unsafe use and management of medicines and the risks of acquiring a healthcare associated infection.
- There must be effective liaison between the contraception and sexual health service and the school nursing service about individual young people who may be at risk of abuse.
The reports highlight some areas of outstanding practice including:
- BreathingSpace, the trust’s nurse-led unit for patients with chronic lung disease provided exemplary care to patients due to the highly skilled and knowledgeable staff working on the unit. Staff were caring and compassionate and continued their caring role by supporting families after the loss of a loved one. It is an innovative community service that meets the needs of the population.
The reports which CQC publish today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations including Healthwatch.
On 13 July the Care Quality Commission 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.
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