200228 | Cornwall hospitals to come out of special measures?
Cornwall hospitals to come out of special measures?
Published by Emma Carton at 3:14pm 26th February 2020. (Updated at 3:21pm 26th February 2020)
The watchdog is recommending Cornwall's main hospitals are taken out of special measures.
The trust that runs Treliske, the West Cornwall and St Michael's in Hayle was rated inadequate at the last inspection.
The Care Quality Commission had raised concerns about patient safety, critical care and maternity services.
Overall, the Royal Cornwall Hospitals' Trust has been rated as 'requires improvement', including for safe and responsive.
However the RCHT has moved onto a 'good' rating in terms of being effective and caring, as well as how well it is being led.
Scroll down to read the findings of the CQC's report in more detail or listen to the hospitals' Chief Executive talk about the improvements it has made.
Royal Cornwall Hospitals' Trust Report Interview
00:00 02:23
Chief Executive of Royal Cornwall Hospitals' Trust, Kate Shields, talks about the Care Quality Commission's report
What were the results of the inspection?
The Board: Inspectors found the board understood the priorities and managed the issues the trust faced. Board members were visible and approachable in the trust for patients and staff. They supported staff to develop their skills and take on more senior roles.
Urgent Care: In urgent and emergency care staff worked together as a team for the benefit of patients. They supported each other to provide good care. However, there were instances where staff did not assess and monitor patients regularly to see if they were in pain or give pain relief in a timely way.
Medical Care: Medical care had enough nursing staff to care for patients and keep them safe and they understood how to protect patients from abuse. Staff assessed most risks to patients, acted on them and kept good care records. However, the service did not have enough medical staff in all areas and staff mandatory training was not fully completed.
Surgery: In surgical services, staff knew how to protect patients from abuse and treated patients with compassion and kindness. They worked well together for the benefit of patients and staff were supported to develop their skills. However, premises were not always suitable. On Trauma 1 ward, many items were stored in a patient waiting area, because of a lack of storage. There was not enough space in one lounge, where three patients were waiting. Some surgical nurses were not trained to look after the acutely unwell medical patients on the surgical admissions lounge.
Maternity: Staff in maternity worked well together to provide good care and treatment and gave patients pain relief when they needed it. They felt supported, respected and valued. Managers monitored the effectiveness of the service and made sure staff were competent. Staff advised people how to lead healthier lives, supported them to make decisions about their care, and provided them with access to good information. A team of midwives supported the travelling community.
End of Life Care: The trust’s end of life service had significantly improved from our previous inspection. The end of life team was working with other organisations across Cornwall to improve services for patients. This joint working was in its early stages but there had been positive responses to an education passport. Nursing staff were providing education sessions and were monitoring work competencies to support an increase in understanding for all community staff and volunteers. Staff treated patients with compassion and kindness.
Outpatients: In outpatients, the specialist nurse for teenagers and young people with cancer provided exceptional levels of support to patients. Every six weeks, the nurse arranged a peer support evening at a local restaurant for young people to meet others who were being treated for a cancer diagnosis. There were enough staff to care for patients and keep them safe and they understood how to protect patients from abuse. Staff worked well together for the benefit of patients and treated patients with compassion and kindness.
What do the inspectors say?
"Royal Cornwall Hospitals NHS Trust has continued to make progress since our last inspection in September 2018. The trust has embedded a lot of the improvements needed.
“In July 2017, we rated the trust as Inadequate overall because of concerns relating to patient safety, the organisational culture and governance. Since that time, we have returned to inspect while continuing to monitor the trust closely.
“The leadership of the trust has worked hard to tackle the issues we reported on and they have jumped from Inadequate to Good in the well-led aspect of the inspection.
“The credit must go to the hard work and commitment of the staff and the current leadership team. I congratulate them on their achievements. While the overall rating of Requires Improvement remains the same, we have identified a number of significant improvements in the quality of services. I am happy to recommend that the trust is removed from special measures".
Dr Nigel Acheson, CQC Deputy Chief Inspector of Hospitals for the South
England’s Chief Inspector of Hospitals has recommended that Royal Cornwall Hospitals NHS Trust should be taken out of special measures after an inspection by the Care Quality Commission.
Although the trust remains as 'Requires Improvement' overall, Professor Ted Baker said inspectors found enough progress to make the recommendation to NHS Improvement.
You can read the full report here.
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