Nurses at a failing hospital trust have told inspectors how they are unable to care adequately for patients due to low staffing levels.
United Lincolnshire Hospitals Trust was heavily criticised by the Care Quality Commission in its latest inspection report.
The trust, one of 14 inspected as part of the recent review by NHS England medical director Sir Bruce Keogh, failed to meet seven essential standards set by the regulator. The CQC found a catalogue of failures and described how nurses became emotional talking about the stresses they faced.
In their report, the inspectors said: “We found a number of nurses became very emotional when discussing the stress of working short staffed. Many reported they were working longer hours, often missing breaks, going off duty late and undertaking overtime by doing extra shifts.
“We spoke with one nurse at 2.30pm; the nurse had been working since 7am and had not had a break, including a drink since starting duty.”
They added: “We were told because staff were rushing all the time sometimes patients were left longer on commodes; some patients received their medications late and hourly observations of patients’ conditions were not always completed. Nursing staff felt it was impossible to always keep up with paperwork and support the needs of the patients.”
Inspectors, who visited the trust on five occasions during June and July, witnessed call bells being ignored with “staff seen to walk by without checking whether the call was urgent or not”.
They also found the drugs trolley had been left open and unattended on a ward with a high number of confused patients. Their report also highlighted handover problems with nurses and doctors failing to communicate.
It stated: “We found all staff spoken with agreed there were staff shortages. Staff reported low staffing levels meant they could not care for their patients as they would wish to do.”
Inspectors carried out checks on patient charts across three wards and found on one ward that out of 21 hourly observation charts, nine had not been completed correctly. On a second ward, they found gaps in eight out of 25 hourly observation charts and on the third, six out of 23 hourly charts had gaps.
The CQC report highlighted a “confusing picture” on decisions not to attempt resuscitation, with poor documentation and one example of a patient being subject to a DNAR without their knowledge.
In addition, inspectors found only 56% of staff had completed mandatory training.
The report said there had been some improvements in staffing levels for nurses, but recruitment remained a challenge.
The trust’s board has recently agreed a £7m investment in additional nursing over two years and has closed 26 beds.
Trust chief executive Jane Lewington said: “It is our top priority to ensure that we provide patients with the best possible care. We are improving, but we know we have more to do.”
The CQC report said: “In the past three years, the Care Quality Commission has continued to raise its concerns about the quality of care provided by this trust. Improvements have not been sustained.
“We will continue to closely monitor the trust, inspecting as required and working with NHS England to review progress.”
As part of the special measures process, health secretary Jeremy Hunt announced this week that struggling trusts would be partnered with more successful organisations to help them improve.
Under the programme, United Lincolnshire has been partnered with Sheffield Teaching Hospitals Foundation Trust.
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