England's chief inspector of hospitals has rated Southend University Hospital NHS Foundation Trust as Requires Improvement overall, following a Care Quality Commission (CQC) inspection.
CQC inspected the trust between 5 November and 12 December 2019.
In addition to its overall rating, the trust is rated Requires Improvement for being safe and responsive. It is rated Good for being effective, caring and well-led.
The trust was previously rated Requires Improvement overall, following an inspection in 2017.
In a separate assessment carried out by NHS Improvement, alongside CQC’s inspection, the trust was Requires Improvement for its use of resources.
Due to the trust’s imminent merger with Mid Essex Hospital Services NHS Trust and Basildon and Thurrock University Hospitals NHS Foundation Trust, in April 2020, it was inspected at the same time as Mid Essex Hospital Services NHS Trust.
CQC chief inspector of hospitals, Professor Ted Baker, said: “Our latest inspection of Southend University Hospital NHS Foundation Trust found the quality of some of its services had deteriorated, as well as some services that were performing well.
“The trust’s urgent and emergency care was not offering the quality of care and treatment seen previously. Staff were caring but training targets, including for safeguarding, had not been met and records were not always comprehensive. There were not always enough nurses on duty and use of facilities and equipment was not optimised. Underpinning this was a lack of oversight from leaders, and the issues meant patients did not always receive prompt care.
“The trust’s surgical service had enough staff with the right competencies but waits for referral and discharge did not always meet national targets. Training targets for medical staff in the service were not met and there was not enough evidence to assure us infection risk was well managed.
“Medical care – including stroke and cardiology units as well as wards for older people – was a Good service. Staff met patients’ individual needs effectively, but records and equipment were not always stored securely.
“People using maternity and outpatients were treated with kindness and compassion by staff who maintained privacy and dignity in Good services. However, maternity needed more staff to ensure patients were safe, and referral-to-treatment times in outpatients – including for cancer patients – were below national targets.
“Following the inspection, we reported our findings to the trust. Its board knows where it has issues to address. We continue to monitor its services, and this will include future inspections following the merger with Mid Essex Hospital Services NHS Trust and Basildon and Thurrock University Hospitals NHS Foundation Trust.”
CQC has told the trust it must make some improvements, including:
- Meeting training targets, including for safeguarding
- Sufficiently maintaining on-duty nursing staff levels
- Following processes when dealing with patients suspected of carrying infectious diseases, and ensuring cleaning records are up-to-date
- Ensuring patient call bells and emergency alarms work
- Overseeing all waiting areas, ensuring fire exits are accessible and ensuring clear signage of all patient call points
- Correctly calculating early warning scores – a measure for detecting and responding to patient deterioration – with outcomes recorded and escalated accordingly
- Completing all risk assessments and checklists
- Ensuring patient records are clear, accurate, up-to-date and stored securely
- Using robust processes to share key information with other care providers
- Using audit findings to improve care
- Appraising staff performance regularly, and holding supervision meetings to provide support and development
- Meeting national targets for accident and emergency departments waits
- Ensuring medicine fridge temperatures are checked and recorded in line with policy and ensuring a clear escalation process for when temperatures are outside recommended ranges.
Inspectors witnessed outstanding practice, including:
- A ‘dementia bus stop’ in urgent and emergency care, consisting of a bench, timetable and bus stop sign. This aimed to minimise anxiety and stress in people with dementia.
Full reports for the trust will be published on CQC’s website tomorrow (Friday 6 March) at the following link: www.cqc.org.uk/provider/RAJ
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