England's Chief Inspector of Hospitals has issued a warning notice to North Essex Partnership University NHS Foundation Trust following a Care Quality Commission (CQC) inspection.
The focused inspection took place on 14 and 15 September 2016 to check on whether improvements had been made following CQC’s previous inspection in August 2015. Inspectors also needed to check on concerns that had been highlighted through CQC’s own monitoring of the trust.
Concerns included whether the trust was learning from incidents and taking action to prevent those incidents happening again, whether the trust was safeguarding patients adequately and whether it was involving patients and carers in their care.
CQC’s previous inspection in August 2015 found a number of improvements were needed and it was rated as Requires Improvement overall.
On their return inspectors found that while some improvements had been made there were still a number of concerns, particularly in relation to the trust’s governance systems.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“Our return to North Essex Partnership University NHS Foundation Trust found that improvements were still needed.
“We could see that much work had been done since our visit in August 2015 and that there were a number of areas of good practice at the trust. The majority of patients gave positive feedback about their care.
“However, we were concerned that improvements were needed in a number of areas. This included the trust’s assessment and management of risks for fixed ligature points on wards, there were concerns relating to the provision of segregated accommodation for men and women and learning from incidents needed to be shared with staff.
“Following our inspection we issued a warning notice which requires the trust to make immediate improvements in relation to its governance systems as result of these concerns.
“The trust leadership knows what it must do now to ensure these changes take place. We will continue to monitor the situation at the trust and this will include further inspections.”
The trust has been told it needs make improvements in a number of areas including:
- Staff need to assess risks on wards and manage risk from ligature points, including on those wards where there are poor lines of sight.
- Areas that admit both men and women need to comply with the requirement to provide same-sex accommodation.
- The trust needs to share learning from incidents effectively with staff, and update its incident reporting policy and procedures to reflect national guidance.
- The trust needs to ensure wards are fully staffed and that staff receive clinical supervision and regular training.
- The trust needs to ensure a consistent approach to administration and storage of medication across acute and wards for older people.
- Patients’ records need to show detailed information, including any risks, and be regularly updated.
Inspectors also found some examples of good practice at the trust, which included:
- The majority of patients gave positive feedback about the staff and their experience of care on the wards.
- Ward staff used regular agency and bank staff to ensure patients received consistent care.
- The trust had an independent ‘Guardian Service’ for staff to contact regarding any matters relating to patient care and safety or staff concerns.
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