A warning notice has been issued to Sherwood Forest Hospitals Foundation Trust after a highly critical inspection report found “abysmal” staffing levels.
Inspectors from the Care Quality Commission found there were not enough nurses or doctors on the wards and described a string of failures at the trust which is already in significant breach of its license with Monitor.
The trust is already in “special measures” after being one of 14 hospitals criticised in a review by NHS England medical director Sir Bruce Keogh following concerns over high mortality rates.
During inspections in June and July the CQC visited the trust’s accident and emergency department and 16 other wards. Inspectors also spoke to 75 patients and 100 staff.
Inspectors were told by patients that staffing levels were “abysmal” and one relative said: “My wife rang me in tears because she could not get any one to help her, they are so busy.”
Nurses told the CQC staffing levels were “horrendous”, with one saying: “We cannot go on, it’s terrible, nurses are crying because it’s so bad on here.”
Another added: “It feels like we’re being told there’s ‘no agency, no bank [staff available] – get on with it.’”
An analysis by the CQC found the trust had a ratio of nurses to healthcare assistants of 50:50 on most wards. The older people’s wards had one nurse for eight patients during the day and one nurse for 12 patients during the night.
The Royal College of Nursing has previously recommended a minimum registered nurse to patient ratio of 1:5 for older people’s wards and a skill mix of 65:35.
Junior doctors told inspectors working on the medical ward at the weekend was “one of the worse jobs” because of a lack of staff and mistakes had been made with prescriptions due to high workload.
The CQC identified problems with the way outlying patients on wards away from the specialty providing their care were reviewed. One nurse saying part of their role was “having to be a good detective” to identify responsible consultants.
Inspectors also found patients not being helped to eat or drink with poor charts and incorrect or absent risk assessments.
The trust also had a backlog of complaints, x-rays and scans.
Trust chief executive Paul O’Connor said: “We are confident that measures have been put in place to address all findings from these reports and recognise the need to give additional attention to bring further improvements for our patients.”
GMB regional officer Harry Harrison said his union hadraised “serious concerns” over inadequate staffing levels and the standards of patient care for a number of years.
“The the trust have been ‘gambling’ with the ratios of qualified nurses to the number of patients they care for as it was a board game.
“GMB members have time and time again raised serious concerns with nurse managers and service directors alike only to be patronised and seen as troublemakers,” he claimed.
Are you able to Speak Out Safely? Sign our petition to put pressure on your trust to support an open and transparent NHS.
Information supplied to HSJ