An unannounced inspection at Wexham Park Hospital in Slough found evidence of inadequate care, regular short staffing on “almost all wards”, and a culture where “staff did not always feel they could raise concerns”.
The Care Quality Commission has told Heatherwood and Wexham Park Hospitals Foundation Trust, which runs the hospital, to make urgent improvements, after inspectors concluded it was more focused on “responding to… targets” than “ensuring that overall patient experiences were positive”.
Findings from the CQC’s visit to the trust in October were published today. It discovered poor standards of cleanliness and inadequate infection control, evidence of poor record keeping, and that “people’s privacy and dignity was not always respected”.
Of the nine standards checked during the inspection, the trust was judged to have failed all except one – management of medicines.
The regulator raised concerns over leadership and care delivery in Wards 7, 4 and the Acute Medical Unit, where inspectors saw a number of occasions where the quality of care given to patients was below standard.
Inspectors also heard complaints from patients about the quality of nursing care and poor communication, which had resulted in people’s privacy and dignity not always being respected.
Despite a previous warning from the CQC about staffing levels and on-going recruitment efforts by the trust, almost all the wards inspected were found to be regularly short staffed.
In addition, staff did not always feel they could raise concerns or make suggestions, the CQC said, and number of staff expressed concerns about bullying and harassment from managers. In some cases, staff raised concerns with inspectors but were reluctant to be named for fear of reprisals.
CQC regional director Adrian Hughes said: “We found there was a clear emphasis on responding to national and local clinical targets but less emphasis on ensuring that overall patient experiences were positive.”
Mr Hughes added that the regulator would monitor the trust’s improvement actions “closely”, and that it would return to inspect the trust on 11 February.
It is not the first time the CQC has raised concerns and issued warning notices to the trust, which provides services to a population of 450,000 across Ascot, Bracknell, Maidenhead, Slough, south Buckinghamshire and Windsor.
Following an inspection last May, the CQC released an equally damning report which identified quality and management failings and similar problems with staffing levels and patient dignity.
Responding to today’s report, the trust said it was taking a “two-pronged approach of extra training… and improved performance management to ensure all our staff deliver acceptable care”.
It said it had invested over £2m in new staff in the last 12 months and would “continue to actively recruit and use temporary staff where necessary”.
The trust added: “We are disappointed that we have not made as much improvement as the CQC believed we should have in five months. We are committed to making sustainable change and will continue to work hard to drive the improvements we all want to see.”
Following the CQC’s latest warning notices, its fellow regulator Monitor announced a package of regulatory measures to try to help the trust improve.
These include appointment of an improvement director to hold management to account against their action plan, and provision of external expertise to support the trust.
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8 January 2014