A Yorkshire trust has seen its Care Quality Commission rating improved, after making progress on mandatory staff training and developing an open culture – though workforce issues remain.
Leeds Teaching Hospitals NHS Trust has been rated as “good” after a follow up visit by CQC. The trust had previously been rated as “requires improvement” in 2014.
“Staff spoke positively about the culture within the organisation”
Following an inspection in May this year, the trust has now been rated as “good” overall, said the CQC in its latest report on the organisation, which was published last week.
The trust received the same “good” rating for the categories of caring, effectiveness, responsiveness and well-led. However, safety remains rated as “requires improvement”, said the CQC.
Individually, the sites of Leeds General Infirmary and St James’s University Hospital were both rated as “requires improvement”, while Chapel Allerton Hospital and Wharfedale Hospital were “good”.
The CQC carried out a follow up inspection of the trust from 10 to 13 May 2016, and also undertook an unannounced inspection on 23 May.
The trust had a “much improved” mandatory training programme, said the CQC, but it warned there were still low completion levels in areas such as resuscitation and role relevant safeguarding.
“Like many hospitals, we continue to face challenges in recruiting sufficient qualified staff”
Other positive findings included that inspectors found “outstanding examples” of record keeping in the care of the dying person care plan, and generally saw that staff recorded sensitive issues in a clear, comprehensive way that enabled safe care to be given.
The CQC saw good use of multi-media including the development of Leeds Children’s Hospital TV, which allowed families to explore the wards and meet the teams that would be treating them.
CQC chief inspector of hospitals Professor Sir Mike Richards said the latest visit had revealed an improvement since the regulator’s last inspection at the trust in 2014.
“Since the last inspection there was a much improved mandatory training programme, the trust had invested time, effort and finances into developing a culture that was open, transparent and supported the involvement of staff, the leadership team had remained stable,” he said.
Sir Mike Richards
“In addition, inspectors witnessed strong leadership of services and wards from clinicians and ward managers,” he said. “Staff spoke positively about the culture within the organisation.”
However, Sir Mike noted that inspectors had identified a “number of areas where staffing levels might compromise safety” and that needed to be addressed.
“There were occasions when nurse and care support worker staffing levels were below the planned number,” he said.
In addition, he said: “Nursing, midwifery and medical staffing levels did not meet national guidelines in some areas, particularly surgery, theatres, critical care, maternity and children and young peoples’ services. The trust need to address these issues.
He added: “The trust must ensure that staff maintain patient confidentiality at all times, including making sure that patient identifiable information is not left unattended. In addition, the trust should also ensure that infection prevention and control protocols are adhered to in theatres.”
But Sir Mike told the trust he was “satisfied” that the remaining issues needing improvement could be “rectified”.
“Overall, this report represents good progress,” he said. “The trust is to be congratulated, but I would like to see further progress in those areas we have identified.”
The CQC highlighted that its inspection and report had already been completed before the trust experienced high profile problems with their pathology IT system last month.
Julian Hartley, chief executive of Leeds Teaching Hospitals, said he was “delighted” the CQC had found that “very significant improvements have been made in patient care across our hospitals”.
“On a personal level, I was very pleased that the inspectors have acknowledged that the huge amount of effort put in across the organisation to develop and open and accountable culture where staff feel empowered and involved has started to show benefits,” he said.
Mr Hartley added: “Of course, there are always improvements to be made and the report does highlight areas where further work is needed.
“Like many hospitals across the country we continue to face challenges in recruiting sufficient qualified staff, but we have committed £13.5m over 30 months to address this,” he said. “Overall the trust has around 1,500 extra staff compared to two years ago.”