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'Serious concerns' over nurse staffing remain at Mid Yorks

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“Serious concerns” about nurse staffing remain at an acute and community trust in Yorkshire, according to inspectors, who rated the safety of services at the organisation as “inadequate” for the second time within a year.

The Care Quality Commission re-visited Mid Yorkshire Hospitals Trust over the summer, after it had carried out an inspection in 2014.

Following its inspection in July 2014, the CQC said it had “significant concerns” about nursing shortages and found on some occasions there was a ratio of one nurse to 22 patients.

“The trust must continue to tackle staff shortages and ensure patients receive the care they need”

Mike Richards

Since then services in medical care, end of life and community inpatients had either deteriorated or not improved, said the CQC in its latest report on the trust.

During its inspection this summer, it again found “significant shortages” of nurses, with evidence of shifts in community inpatient units being staffed with a ratio of one nurse to 26 patients.

This service was failing to assess the dependency levels of patients as part of staffing considerations and was also using a high proportion of non-permanent workers to fill rota gaps, with 96% of shifts in a month featuring at least one temporary worker.

The regulator also found that, while reports to the board said adult inpatient wards were being staffed with one nurse to eight patients in the day, analysis of data by the CQC found this was not being consistently achieved.

Almost 470 incidents relating to staffing were reported between January and March, with a further 129 in April and 181 in May.

Sir Mike Richards

Sir Mike Richards

Sir Mike Richards

Meanwhile, inspectors found areas in accident and emergency departments, and in the mortuary at Dewsbury District Hospital that were not clean, plus reports detailing a “fluctuating” rate of pressure ulcers.

Particular problems at the trust’s Pinderfields Hospital prompted inspectors to return for another “focussed” inspection just in this hospital later in the summer.

It found the trust had introduced safe staffing escalation policies for inpatients, but that this was not being consistently used.

Staffing levels had led to avoidable incidents, said the CQC, including one patient who was not given one-to-one care and subsequently injured themselves. After recognising the incident, staff failed to arrange one-to-one care for the next night.

Concerns about fluid balance charts and nutritional assessments not being completed were also raised.

When inspectors went back to check on this particular hospital again in September, charts were still not fully completed.

However, at this later date they did find improvements in some areas, including additional support staff being brought in to help registered nurses on wards, and matrons being transferred to help with “hands on” care.

Mike Richards, CQC’s chief inspector of hospitals, said: “When we inspected the hospitals run by the Mid Yorkshire Hospitals Trust, we saw that the trust had made some clear improvements to improve the safety and quality of services since our previous inspection in 2014.”

He added: “However there is still work for the trust to do to ensure that people using its services consistently receive good quality care and treatment.

“Set against financial constraints and increasing demand we have made demonstrable achievements”

 Jules Preston

“The trust must continue to tackle staff shortages and ensure patients receive the care they need”

A statement from the trust said since the CQC inspection it had employed an additional 100 nurses and had a £1.2m recruitment drive planned for the new year.

Trust chair Jules Preston said: “The story of this report is one of continued progress and an encouraging cultural shift.

“Of course we would like to see the trust performing to the very highest standards in all that we do but set against financial constraints and increasing demand we have made demonstrable achievements.”

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