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London hospital branded 'Unsafe and dirty'

An NHS trust has been issued with three formal warnings after inspectors found “unsafe” conditions including filthy maternity wards and water placed out of the reach of elderly patients.

Barts Health Trust has “failed to protect the safety and welfare of patients” at Whipps Cross University Hospital in Leytonstone, east London, the Care Quality Commission (CQC) said.

The trust must now make “urgent improvements”, following unannounced inspections in May and June.

The hospital was failing to meet 10 of the 16 national standards for quality and safety, inspectors found.

On maternity wards, “serious shortfalls” were noted, such as blood-stained equipment, filthy curtains, staff not cleaning their hands and midwives failing to carry out proper checks on newborns.

Resuscitation equipment for babies did not have an oxygen supply and was not checked regularly, while some equipment was not sterile, inspectors found.

“We saw examples of poor care, unacceptable staff behaviour and poor infection control in maternity services,” inspectors said in their report.

“In surgery, theatre processes and communication arrangements put people’s safety at risk.

“Surgery and maternity were both too busy, did not have enough staff to look after people’s needs and lacked bed capacity.

“The management at Whipps Cross are not adequately managing risks in either maternity or surgery.”

During just one visit, inspectors identified “serious shortfalls” in eight out of the 16 essential standards hospitals are required to meet by law.

Staff on postnatal wards were found to be “uncaring”.

The report said: “We saw a woman in a blood-stained gown and bed. About 10 minutes later we saw the same woman crying in the corridor. The midwife on duty asked the woman ‘Why are you crying?’ The woman replied ‘I am in pain’. ‘Pain!’ the midwife repeated in a sarcastic manner.

“The midwife got some medication and handed her a white pot which contained tablets without telling the woman what the tablets were.

“We observed the same midwife bringing the wrong formula milk (as it was different to what the woman had previously been feeding her baby). When asked by the woman, the midwife did not accept she had brought the wrong milk and did not offer the woman the correct alternative.”

Care to mothers was “not always delivered safely” and some babies were admitted to intensive care, “related to a failure by midwives to carry out the correct observations at the right time and escalating matters when required”.

Staff did not wash their hands enough, putting babies, mothers and visitors at risk of infection.

“On the labour ward, there were stainless steel bowls on stands in some delivery rooms. We saw a blood-stained bowl in a delivery room which was described as a room ready for use. We found another room, that a midwife had said was ready for use, had stains on the disposable curtains,” the report said.

Inspectors also found shortages of staff on elderly care wards, including a lack of qualified nurses.

Care plans were not always updated and there was one fall on Bracken ward and 11 falls on Blackthorn ward, mostly at night, in an 11-week period.

While patients were checked for pressure ulcers on admission, inspectors found that five patients acquired ulcers in hospital.

Checks on feeding tubes were also not always carried out properly, the inspectors noted.

There were also problems in A&E with patients spending too long waiting to be seen. The national NHS target is for 95% of patients to be seen within four hours but the hospital has not met this target since November last year.

Between January and March, on 31 occasions patients had to wait more than 60 minutes from the time the ambulance arrived at hospital until a handover was completed, although the hospital said emergency attention was provided on the trolley when required.

The trust has now been told to improve in three key areas: cleanliness and infection control; safety, availability and suitability of equipment; and support given to staff.

Matthew Trainer, regional director of CQC in London, said: “We have very serious concerns about the care and treatment patients have been receiving at Whipps Cross University Hospital.

“The reports we have published today show a systematic catalogue of failings across the departments we looked at during our inspections in May and June,” he said.

“We found that, in places, the hospital was unsafe and dirty, and that staff didn’t always show patients the compassion that people deserve.”

In a statement, the trust apologised and said it was making “urgent improvements” to patient safety and standards of care at Whipps Cross University Hospital following the CQC inspections.

Barts Health chief executive Peter Morris said: “We are extremely sorry for the failings in some of our services at Whipps Cross Hospital. We have taken immediate action to rectify the failures to ensure we meet standards across the hospital at all times.”

He cited the trust’s “Great Expectations” maternity programme, which has recently been introduced to support the improvement of training and care standards, and said all 500 staff working on elderly care wards were following an intensive “Excellence in Older People’s Care” programme.  

In addition, a Care Campaign was launched this month, to reinforce environment and cleaning standards, the importance of patient and staff feedback and ensuring team meetings, appraisals and supervision are in place in all clinical areas.  

Barts Health chief nurse Professor Kay Riley said: “Our care campaign is our opportunity to relentlessly focus on patients’ best interests, to keep patients safe and to create a climate of care where we are open and candid, we relentlessly pursue excellence and all our staff are compassionate, caring and committed.”

 

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Readers' comments (23)

  • Scrap the CQC! Who needs them? The answers to all problems with health care are as simple as they are unfundable, we need more nurses, more HCA's, more doctors, bigger and more modern hospitals and a population that understands how to look after its own health! Having whining bureaucrats telling us that this is dirty and that is unsafe doesn't help! It just adds to the misery.

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  • actually - there is no need at all for more funds, there is no shortage at all of money - but a huge shortage of ability to be efficient with that money. The last government DOUBLED the amount coming in the the NHS. it is NOT about money. How about a bit of easy to fix care and attention and less time looking at iphones and chatting nurses stations?. The responsibility for all the people who receive substanbdard care and attention lies totally with every single person who walks past the bed of a patient in need and does nothing to help them. We all know it goes on and to keep blaming people higher up and faceless is unacceptable. The care starts with the person supposed to be holding the patients hand and telling them we are there to help!

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  • So well said Anonymous 14 august at 12:50pm :
    Please stop blaming people higher up - it's not solving the problems we face every day.
    The problems, all of them, lie with our nurse managers, and our colleagues. The buck stops with the people who are with the patients - nurses. It is up to us to have the guts to tell our colleagues that are letting our profession down & giving us a bad name, that we will report them. I prefer peace of mind at work ahead of money.

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  • Some times money helps but you can't buy a caring attitude. Sarcastic midwives treating new mums like dirt? Yes well I've been on the receiving end of that and I would sack them.

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  • I suppose once you have run out of groups of people to blame, apart from the patients, you have to find something else such as the money first of all, and then each in their turn various other material resources, and perhaps even the localities.

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  • Anonymous | 14-Aug-2013 12:50 pm

    I agree that no more money is needed. Proper management of existing funds would provide the level of staffing and resources required. Much as you may like to deny it, those in senior positions are largely to blame and to ignore that by foisting the total blame onto nurses is unacceptable. I also, to an extent, blame nurses for the lack of action they have taken to stand up for the rights of their patients and themselves. I speak of the many who do not take their breaks and waste hours staying behind to complete their work. This hides the reality of chronic staffing levels and leads to nurses taking the hit for every fault found within any NHS Trust. A win win situation for the government and management. Of course there are nurses who fall below the standard, but the overwhelming majority provide excellent care under increasingly difficult conditions. My wish is that they take a leaf out of their Aussie colleagues book and take to the streets in massed protest to improve these conditions. I think that there would be a widespread wake up call and realisation of the fantastic job done by the majority of nursing professionals. Bash away. But you'll miss us when we are gone. I guarantee it.

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  • In my experience as a nurse in Intensive Care and as a Business Consultant iworking on the Frontline Connect Programme for NPfIT I am always amazed at the lack of personal accountability and integrity.
    Having experienced both bad medical and nursing practice and having brought these to the attention of the individuals and their managers I was surprised that little action was taken or that critisms were not acted upon. Just about every report into the failings of the NHS find that individuals have not acted as they should. If everyone involved treated their patients / carers as they would like to be treated, the care would improve, litigation would fall and the available money, linked to proper processes would suffice.

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  • Pussy

    That's rich coming from them!! Do- gooders and clueless,just another government quango to keep the public happy!GET RID ASAP!

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  • Waken up everyone, if you have staff who are uncaring in the profession then they need to go immediately. This would start with the management(they do not care about anyone apart from themselves especially Nurses who trick the NMC into thinking they still practice and register each year that needs to be looked into as well) then work down the chain. The profession is putting itself into risk of being not trusted by anyone

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  • Waken up everyone, if you have staff who are uncaring in the profession then they need to go immediately. This would start with the management(they do not care about anyone apart from themselves especially Nurses who trick the NMC into thinking they still practice and register each year that needs to be looked into as well) then work down the chain. The profession is putting itself into risk of being not trusted by anyone

    Unsuitable or offensive?

  • In my experience as a nurse in Intensive Care and as a Business Consultant iworking on the Frontline Connect Programme for NPfIT I am always amazed at the lack of personal accountability and integrity.
    Having experienced both bad medical and nursing practice and having brought these to the attention of the individuals and their managers I was surprised that little action was taken or that critisms were not acted upon. Just about every report into the failings of the NHS find that individuals have not acted as they should. If everyone involved treated their patients / carers as they would like to be treated, the care would improve, litigation would fall and the available money, linked to proper processes would suffice.

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  • Are the NMC now going to prove to be proactive !

    I would seem that the whole "nurse management" population needs to be subject to fitness to practice investigation, together with individual nurses/midewives who seem to be strangers to the "code of practise"

    Some need removing from the profession

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  • Jim Madden | 14-Aug-2013 5:19 pm

    Many managers are non clinical and have no regulatory body. Who deals with them?

    Felim McCarthy | 14-Aug-2013 6:01 pm

    Yeah. We heard you the first time. Why don't you step out from behind the computer and into a busy acute receiving ward for a few hours?

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  • it's interesting how things have changed. My mother sadly died on the ITU ward at St Bart's in 1997. She was taken there from Norwich as this was the only bed available (before the big shiny new hospital was built) they couldn't have been more caring. The Nurses and all medical staff looked after my mother and her family with dignity and empathy.

    Shame we are going this way with our NHS, what happened, we didn't suddenly become cold hearted I am sure, and like everything else the good one, the Angels as they were once called are forgotten. Come on as others have said, step up to the plate and speak out, if they don't know what's happening they can't change things, it does start at ground level.

    Maybe it need an outsider to look at thing with fresh eyes............

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  • Are older nurses to tired and dispondent to care what is happening in the NHS? Are the younger less inclined to do the essentilais of nursing care because they have never been taught the importance of these tasks, or don't think it is there responsibility to help a patient wash, eat, go to the loo or be pain free, have medications on time dressings changed, need i go on. No I don't, we all know what needs to be done. Most of us want to do these things to help make patients hospital stay more comfortable, having the time and help from other staff members is what prevents it. Better skill mix is needed, more support from management and most importantly a better system for reporting. Nurses are still the lynch pin, and are expected to ensure that the rest of the MDT have done their jobs, if they haven't it is the nurse that has to chase them. Let those others be accountable for their own short comings in their jobs. Trouble is nurses want patients to go home with the right equipment, medicaions ect so we chase it up, why BECAUSE WE CARE, thats what nurses do.
    Its about time we got acknowledged for this by those in "positions of authority" they should step up to the plate and take some responsibility for letting things slide as far down the slope as they have.

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  • The NHS must be one of the few organisations in the world where more use isnt a good thing, and thats because capacity doesnt increase to meet that greater demand.
    when I need more capacity in my clinical group here in Singapore-I get it.
    I present a business plan,get the funds and implement.
    The NHS seems to think this is a bad thing.

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  • why are they missing the A&E target? hmm, let me think - not enough beds, not enough staff and the NHS being generally under-resourced, and they are thinking of closing even more beds in London.

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  • Anonymous
    We need to ask ourselves why the nurses dont seem to care anymore? We think its being short staffed or the lack of funding. Has anyone thought about motivating the small number of staff available? Identifying the available skills, supporting and giving more rsponsibility? We keep getting managers to manage us and its like a vicious of managers.Most of us are frustrated by nurse mangers who dont give the monkeys about the skills or potential that some of us have. Some of us nurses are managed by managers who dont have the skills we have. Some managers are put in these posts with person specifications designed for them or around them with the tag ' willing to work torwards......" But as soon as they are in the post do they work torwards NO!! insteady they frustrate those nurses under them who have skills they themselves dont have. This has forced a lot of us to go somewhere else or get into a less caring attitude.
    Someone has to put managers through an intense Clinical Decision Makig Process skills course that will benneft patients and staff. As they seem to design person specifications for a job that quailifies unqualified people to be moved into positions of leadership and responsibility to protect their own lack of knowledge and understanding of the job.

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  • Anonymous | 18-Aug-2013 10:30 am

    "We need to ask ourselves why the nurses dont seem to care anymore?"

    Start by not making such sweeping and erroneous statements! This isn't the Daily Wail!!

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  • Here here Anonymous | 14-Aug-2013 12:50 pm
    However we have a huge problem with management in this country. Managers who dont know how to manage. Managers with no expereince of the very people they are supposed to manage. Managers who prefer to refer nurses to the NMC than to actually manage the issue themselves. Manager who dont know how to incentivise the staff they have and would rather beat them down. Managers who are too afraid of standing up to their managers and standing up for their own unit staff for once.
    I am leaving yet another job for this very reason! Sick of managers with no backbone of their own, and who are happy to make their own unit staff miserable and overworked- and God forbid, they should roll up their sleeves and muck in when needed!!

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