The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust has been rated “requires improvement”, following a third inspection by the Care Quality Commission, which found ongoing problems in accident and emergency.
Inspectors concluded the Dorset trust “required improvement” for providing safe, effective, responsive and well-led services, but was rated “good” for providing caring services.
“Particular attention should be paid to patient care and flow in the emergency department”
During October and November, they visited both the trust’s main sites – Royal Bournemouth Hospital, which was rated “requires improvement”, and Christchurch Hospital, rated “good”.
Inspectors found staff were “caring and worked hard” to ensure patients were treated with dignity and respect, said the CQC’s report on the trust.
The regulator noted that trust had invested in staff to ensure safer staffing levels, and staff were “positive” about working for the trust and the quality of care they provided.
They were also positive about the trust focus on improving its culture to one that was more open and transparent and focused on patients, said the regulator.
It highlighted that the trust had involved staff in developing improvement plans to deliver savings and reduce its financial deficit, and staff were being supported and encouraged to innovate and improve services.
Sir Mike Richards
In addition, the trust had improved the effectiveness of its governance arrangements, which now include a better focus on safety at ward level.
However, inspectors found the A&E department at the Royal Bournemouth Hospital had delays in admitting patients, which meant it was often full and could not immediately treat new patients.
An ambulatory emergency centre had been developed by the hospital but inspectors “saw little evidence that it had improved treatment for emergency department patients”.
As a result, the CQC told the trust to ensure A&E patients were assessed and treated according to nationally agreed standards, particularly for sepsis and fractured neck of femur.
The trust was also told to improve on ensuring the privacy and dignity of patents was protected during care and treatment, and to review delays in discharge that led to mixed sex accommodation breaches, particularly in critical care services.
“This is a testament to the high professional standards of all those that work within the trust”
The report highlighted several areas of outstanding practice including the maternity and gynaecology team, which offered support to women that were assessed as being vulnerable.
CQC chief inspector of hospitals, Professor Sir Mike Richards, said: “I am pleased to report that our latest inspection has found that the trust is still making headway in many areas. On this inspection we have found improvements, particularly in the leadership of the trust,” he said. “However, there is still progress to be made.
He added: “We still have concerns and would like to see a more consistent level of service across the trust. Particular attention should be paid to patient care and flow in the emergency department at Royal Bournemouth Hospital.”
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Paula Shobbrook, director of nursing at the trust, said: “I am really pleased that the CQC has seen at first hand the outstanding care that is provided to so many of our patients and this is a testament to the high professional standards of all those that work within the trust.
“The CQC noted that our staff were ‘motivated to offer care that was kind, supportive, and open’ and this is in line with the mission of our trust to give the standards of care we would want for our own families,” she said.