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Trust told it still needs to improve on pressure sores and staffing levels

An east London hospital trust has been told by regulators it still needs to do more to implement systems to assess pressure damage and employ sufficient staff to meet the needs of patients.

The Care Quality Commission said yesterday four of eight conditions imposed on Barking, Havering and Redbridge University Hospitals Trust had been removed following improvements at its King George Hospital and Queen’s Hospital. 

The trust was registered in April this year on the condition that improvements were made across five essential areas of quality and safety: care and welfare of people who use services; cooperating with other providers; safety and suitability of equipment; staffing; and supporting workers.

In particular, the regulator called for action on reducing pressure sores and employing more nurses, as well as ensuring better training on resuscitation and child protection for nursing and midwifery staff.

The condition relating to equipment – to ensure patients were not admitted into beds in treatment rooms, the clinical diagnostic area and the theatres recovery area – was removed in an earlier review carried out by CQC while three more conditions were removed in the latest review.

However, the deadline for meeting improvements in the care and welfare of patients has been extended till 31 December in order to give the trust more time to embed pressure sore documentation.

Additionally, the condition relating to staffing has been partially lifted, after a £2.5m fund made to the trust had resulted in a recruitment drive which increased nursing levels and reduced the vacancy rate to 8.4 per cent from 15 per cent.

CQC regional director for London Colin Hough acknowledged the positive changes made by the trust to address the numerous breaches identified at the time of registration.

He said: “We are encouraged by the progress made by the trust and recognise the trust has worked very hard to reduce the vacancy rate for nursing staff and has also provided mandatory and child protection training for the majority of nursing and midwifery staff.

Mr Hough also expressed concern that patient’s pressure sore management plans were not properly completed at both hospitals.

He said: “The trust has introduced some new initiatives enabling staff to be more focused on patient care. Inspectors noted that patients were generally happy with the care received at both hospitals.

“However, we are concerned that pressure sore documentation is not fully in place, therefore, we have decided to extend the condition until the trust has embedded measures to ensure that staff are rigorous in completing pressure sore management plans.  This will ensure that all patients will experience effective and safe treatment.”

Trust chief executive John Goulston said: “The work of our ‘visible leadership’ audits by the matrons across every patient area each week and the new patient safety walkrounds by executive directors show our commitment to continuous improvement.

“Already we are seeing the results of improvements in care, with the number of patients developing pressure sores being halved this year on our elderly care units. We are introducing new systems and documentation to help nurses spot the early signs and manage the risk to patients.

“We are confident that we will make further progress on pressure sores and other areas in the weeks ahead.”

Readers' comments (5)

  • Well it's nice of the CQC to tell the trust it needs to do these things, especially telling them to get more staff in, but honestly, do they really think things will change?

    I have contacted the CQC before about staffing levels and skill mixes, only to be told there is nothing they can really do. They are a toothless organisation.

    Nothing will REALLY change untill a decent staff/patient ratio is made LAW.

    It should be ILLEGAL for anywhere to have less than 1 staff Nurse and a care assistant for every six to eight patients MAXIMUM.

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  • here here. i totally agree with the above comment. i was looking after 7 patients on my own yesterday and had to do a drug round for 14 patients as my colleague was dealing with an acutely unwell patient for most of her shift. the majority of our patients are bedbound and working on your own you physically cant do everything that you want to do for your patients. i have found that when we are short staffed complaints go up and care is compromised. and then you get the bed manager asking if anyone is being discharged as they have to stop breaches in a&e. they swan around around like most managers chatting and laughing while they watch you struggle. i cant wait to leave the nhs and be in new zealand where i know i will be treated with more respect.all the chief execs want is to meet their targets and sod everyone else

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  • I have left this trust recently as I am too disgusted to work for it any more. I find it worrying how many nurses seem to accept this poor level of service we are offering. I am afraid that newish nurses who have never known any different may believe that this is what nursing is all about. No wonder nurses no longer get the respect and affection they once had from the general public.

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  • Richard White

    Sadly these three comments are not exceptional, I regularly hear similar reports from around the country. Tissue viability is still regarded as a "Cinderella" discipline by many Trust managers - even though High Impact Actions have demonstrated that suitable attention can lead to cost savings!
    Where Tissue Viability is neglected, you can be sure that other key areas of care are also neglected.

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  • Need I say that prevention and treatment of pressure sores is a fundamental aspect of nursing care? Untreated or poorly treated sores can lead to infection and ultimately to a patient dying. Do these managers really want a death on their hands for this reason? Indeed, there is a huge cost saving to be had from not being sued!

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