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Community trust's past failures compared to Mid Staffordshire

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A catalogue of governance and care failings at Liverpool Community Health NHS Trust has been likened to those found at the former Mid Staffordshire NHS Foundation Trust in a damning report.

The community trust has been heavily criticised for pursuing aggressive savings and foundation trust status, which led to a culture of bullying and harassment and substandard patient care.

“The response to adverse incidents was grossly deficient, with a failure to investigate properly and learn lessons”

Capsticks report

The report, by Capsticks Solicitors and published this afternoon, criticised board members for failing to spot and tackle emerging problems and, in some cases, said executives were guilty of downgrading serious risks or incidents and keeping information from other board members.

The review said: “Inappropriate and unsafe care was not addressed, even where that was clearly set out in internal or external reports, and the response to adverse incidents was grossly deficient, with a failure to investigate properly and learn lessons.”

The report said the trust’s culture was seen as “oppressive” with staff “driven to the brink.”

Review author Moosa Patel said fears over acutely ill patients being cared for on intermediate care wards with 100 beds were downgraded by executive directors and other escalated risks were also downplayed.

“I believe we now need a full clinical inquiry”

Rosie Cooper

He said: “For many of these concerns, it is hard to come to any other conclusion than that they were managed in the way they were in order to ensure the trust application for NHS foundation trust status remained on track.”

He said the board had ignored key findings from the Francis inquiry into poor care at Mid Staffordshire about the dangers of poor culture included disengaged staff, target driven priorities, isolation, lack of candour, bullying, low staff morale, discouragement of feedback from trainees, acceptance of poor behaviours, reliance on external assessments and denial.

He added: “We found, almost without exception, the presence of all these factors within the trust to varying degrees.”

Liverpool Community Health NHS Trust

Community trust’s failures compared to Mid Staffs

Rosie Cooper

The report has prompted Rosie Cooper, Labour MP for West Lancashire, to call for a public inquiry into care failings at the trust. She complained about the treatment of her father by the trust in 2013 and has raised concerns from whistleblowing staff.

She said: “I believe we now need a full clinical inquiry to establish the full extent of any harm that has been caused to patient care and staff welfare.”

In one incident, the trust failed to properly investigate after a member of staff was taken hostage and subjected to a serious assault by the relative of a patient.

The report said: “It was not until over two years had elapsed since the assault had occurred and a year since the chief executive had left the trust that she became aware of the true extent of what had happened to a member of staff whilst she was the accountable officer for the trust.”

It added that the response to the incident “calls into question the experience and judgement of each and every one” of the executive team.

“It is our view that the handling of this incident by the senior management team was significantly flawed and represented a serious breach of NHS Code of Conduct and the Nolan Principles,” it said.

Other key findings include:

  • An “inexcusable and wholly unprofessional” failure by executive directors to be “open and transparent” with the wider board including not sharing staff survey results showing 96% of staff believed bullying was a problem at the trust
  • Cost improvement programmes were “hugely challenging and in many cases ultimately unrealistic without significantly compromising the safe delivery of care”
  • The failure to recruit and carrying unfilled posts to deliver cost savings resulted in poor staff experience and inconsistent quality of services. “Despite this, cost improvement programmes were nevertheless driven forward persistently”
  • Regulators and commissioners failed to question the quality impact of the trust’s cost improvement programmes and to provide “appropriate scrutiny and challenge”
  • The appointment of an inexperienced team was highlighted as a source of issues at the trust

The report, commissioned by a new interim leadership team at the trust and the NHS Trust Development Authority said there was a “sustained drive towards achieving NHS foundation trust status by the board” since 2011.

It added: “What followed until the early part of 2014 was an accompanying focus to reduce costs, which resulted in enormous pressures on many frontline services and the emergence of a culture of bullying and harassment of staff at various levels within the organisation and the delivery to some patients of poor and in some cases substandard care.”

“We are sorry that these issues went unchecked and unchallenged for so long”

Carole Panteli

In January 2014 the Care Quality Commission raised concerns about the trust’s culture and staffing numbers and issues the trust with two warning notices.

In 2014, trust chief executive Bernie Cuthel stepped down from her role, along with director of operations and executive nurse Helen Lockett and director of human resources Michelle Porteus.

Liverpool Community Health abandoned its plan for achieving foundation trust status in 2015.

Carole Panteli, the trust’s interim director of nursing, said: “The report is clear that the trust lost its way a number of years ago and this can be seen in the sad catalogue of historical problems, which climaxed in a series of critical inspection reports in early 2014.

Liverpool Community Health NHS Trust

Community trust’s failures compared to Mid Staffs

Carole Panteli

“What happened historically was wrong and, on behalf of the trust, we are sorry that these issues went unchecked and unchallenged for so long,” she said.

Ms Panteli added: “Since the appointment of our new leadership team in April 2014 and embarking on our improvement journey, we’ve recruited more than 150 nurses, health visitors and other frontline clinicians.

“We’ve turned an important corner but it’s important we never go back to the problems of the last few years,” she said. “Today’s report confirms that we are heading in the right direction but we are by no means complacent about the challenges that lie ahead.”

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Readers' comments (6)

  • michael stone

    The same story, again, it appears.

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  • Yes Michael, please note lack of meadia coverage as usual, imagine if this had been a small Nursing Home ?
    Why the disparity I wonder, where was "Safeguarding" do they only exist to harrass the Private Sector, let us see whom is held reponcible (if anyone) and who gets the golden handshake and promoted.
    They can not ever plead poverty as they get around £3000 per week per person for this service compared to £700 in a Nursing Home (Paid by CCGs)

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  • I would really like to know what you mean by an inexperienced team? Perhaps they were in retail before as seems to happen with many executives who jump at the pay - and also how much did they all get paid off when they left in disgrace? I will check in FOI as this is definitely in the public interest to know and it is likely that their golden handshakes would fund many nurse for many years- as usual

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  • I think this isnt new...its happening in all hospitals and trusts community and others I suspect. its def happening in the Trust I work in. Bullying of nurses , overpricing care and measuring patients dependancy at a 2 instead of 1 so the Trust can get more money from the commissioners.

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  • Cough - wilful blindness as body corporate? Sneeze - What is the HSE doing? Sniffle - Is it possible there are many more cases nationwide? Cold Catching - Has the HSE repeatedly not acted in such cases?

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  • The powers that be will hold another drawn out enquiry at the end of which Nothing will happen, in the mean time Panorama will do another "undercover" investigation into some small "care Home" to show how bad it is in the "Private Sector (for profit) " and the show will go on and nothing will change.

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