England's Chief Inspector of Hospitals has recommended that Kettering General Hospital NHS Foundation Trust exits special measures following a Care Quality Commission inspection.
The trust was rated Inadequate overall and placed into special measures following an inspection in October 2016. CQC returned in November 2017 and, while improvements had been made, it remained in special measures.
Between 5 February and 14 March 2019 inspectors visited the trust’s core services of urgent and emergency care, medicine, maternity, and outpatients and diagnostic imaging and carried out an inspection of the key question of whether trust is well-led. They found further improvements had been made and, while further work is needed, Professor Ted Baker is recommending the trust now exits special measures. The trust is rated as Requires Improvement overall.
Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:
“Our return to Kettering General Hospital NHS Foundation Trust showed further improvement had taken place and previous improvements had been maintained. This is why I am recommending to NHS Improvement that the trust now comes out of special measures.
“At our October 2016 inspection, the overall rating for the trust was Inadequate with two of the five key questions we ask, safe and well-led, also being rated as Inadequate. Since then - during both our inspection in November 2017 and our most recent inspection - we have found steady improvement being made at the trust, with the support it has received through being in special measures.
“As a result of the inspection the trust’s leadership is now rated as Good. We found the trust had managers with the right skills and abilities and there was a mix of experience within the executive directors.
“There was a clear vision and strategy developed with staff and the executive team and that managers promoted a positive culture which supported and valued staff, creating a sense of common purpose based on the trust’s shared values.
“There were improvements in the majority of the core services we inspected. Maternity services and diagnostic imaging’s overall ratings improved and are both now rated as Good and, although more work is needed, we found improvements in urgent and emergency services which is now rated as Requires Improvement overall.
“Our inspectors found a dedicated staff at the trust who had worked hard to ensure improvements were made and they witnessed aspects of outstanding care in the maternity service. In diagnostic imaging, significant improvements had been achieved resulting in considerable reduction to the reporting backlog found at the last inspection. This meant results were now available in a timely way.
“However, there is still work to be done in ensuring people always receive the treatment and care they should be able to expect. The trust board knows what it needs to do now and we will return to check on their progress with improvements at the trust.”
The trust has been told it must still make a number of improvements. This includes:
- In urgent and emergency services the trust must ensure that patients receive initial assessment and observations in a timely manner in line with national standards.
- Nursing risk assessments and safety checklists must be completed.
- Children and their families must not wait to be seen for treatment in an adult environment.
- Pain relief must be administered in a timely manner and pain must be re-assessed after receiving pain relief medicines at regular intervals.
- All staff follow the trust infection prevention and control policy regarding hand hygiene procedures.
- Medicines cancelled on medicine charts are appropriately signed and dated at the time of cancellation
- All complaints must be managed in line with trust policies.
Inspectors also found examples of outstanding practice at the trust, notably in the maternity service where women using the service were supported to live healthier lives and manage their own health, care and well-being.
In 2018, the hospital was re-accredited with the UNICEF baby friendly initiative stage three. This is the top award accredited to organisations by UNICEF. This meant that the trust was committed to supporting and promoting mothers to initiate breastfeeding and educate staff about infant feeding.
Kettering General Hospital NHS Foundation Trust is rated Requires Improvement overall as well as for whether its services are safe, effective and responsive. It is rated as Good for whether services are caring and well-led overall.
Full details of CQC’s inspection, its ratings for the trust, including a ratings grid, are given in the report published online at: www.cqc.org.uk/provider/RNQ