“Significant concerns” about nursing shortages have been identified at Mid Yorkshire Hospitals NHS Trust by the Care Quality Commission, which judged the safety of services as “inadequate”.
The regulator had “serious concerns” during its inspections in July about staffing levels on a 46-bed acute respiratory care ward at Pinderfields Hospital.
“There is no doubt they have a considerable challenge and we need to see that the trust has taken our findings seriously and that they will make the necessary changes at pace”
The trust subsequently closed six beds, ensuring there was one nurse for every eight patients. But duty rotas for August, later given to the CQC, revealed beds that had previously been closed had been reopened and “the majority of the shifts did not meet nurse to patient ratios, particularly on night shifts.”
On some occasions there was a ratio of one nurse to 22 patients, said the CQC said in its report on the trust.
Following this, the trust’s director of nursing confirmed that beds had been re-closed, said the report.
The regulator added that the NHS Trust Development Authority had now taken over monitoring staffing levels and patient safety on the ward.
The CQC noted that patient safety concerns had been raised about the same ward over many months leading up to its inspections.
Evidence to support an allegation of neglect had been identified by the local authority’s safeguarding board in December, and increasing concerns of patient harm on the ward had led to a review by the trust’s senior nursing team in May, said the CQC.
“Despite this, at the time of our inspection significant concerns remained,” said the CQC. “This meant the trust had not taken appropriate and sufficient actions to mitigate the risks to patient harm since they first became aware of concerns seven months previously.”
Other findings from the inspection at the trust – which included Dewsbury and District Hospital and Pontefract Hospital – showed that staff morale was generally low across acute services due to shortages of staff and their movement between areas.
The CQC noted that the trust had been on the verge of administration up to two years earlier with a large underlying financial deficit, which had a significant impact on the provision of services.
In spite of this, staff working in acute services were “compassionate and treated people with dignity and respect”, said the report.
Meanwhile, outstanding practice was found in some of the trust’s community services, including a newly-created multidisciplinary community health and care services team for adults with complex needs.
The CQC also praised the trust’s health visiting teams that had creates a liaison role to work closely with GP practices around safeguarding and to share good practice.
CQC’s chief inspector of hospitals, professor Sir Mike Richards, said that while patients were treated in a sensitive way, he was “very concerned” about staff shortages impacting on the safety and quality of care.
“While the trust has put systems and processes for improvement in place there is no doubt they have a considerable challenge and we need to see that the trust has taken our findings seriously and that they will make the necessary changes at pace,” he said.
Stephen Eames, chief executive of the trust, said: “Our patients have given our staff high praise for the care they receive and I am truly proud of the way they have represented us.
“However, the report highlights a number of issues and concerns, including the potential of risk to patient safety in some of our services, which the board and I are taking very seriously,” he said.
“We started taking action to address safe staffing levels in February this year and we have invested £1.2m in recruiting more qualified nurses across the trust,” he said. “Around 100 nurses have started working here since the CQC inspected us in July.”