A hospital trust in the East Midlands has been told to ensure that its nursing staff follow guidelines requiring them to screen patients for sepsis, among a range of improvements that are needed.
University Hospitals of Leicester NHS Trust must take action to ensure nursing staff adhere to its guidelines for screening for sepsis on wards and the emergency department, said inspectors.
“The trust recognised it needed to make improvements to how it managed the care of deteriorating patients and sepsis”
The Care Quality Commission also warned the trust that standards of cleanliness and hygiene must be maintained to prevent and protect people from healthcare-associated infections.
Hazardous substances must be stored in locked cabinets and the trust must ensure staff know what reportable incidents are, in order to ensure they are reported in a “consistent” and “timely way”.
In addition, the CQC informed the trust that children aged under 18 must not be admitted to wards with patients who are 18 years and above without supervision.
Action must also be taken by the trust so it complies with single sex accommodation law in the diagnostic imaging changing areas and it must provide sufficient gowns to ensure patient dignity.
Meanwhile, patient tests must take place in a way that “maintains patients’ privacy”, said the regulator after its latest inspection at the trust.
Overall, the CQC rated the trust as “requires improvement”, following an inspection that took place in June 2016 – meaning it received the same rating as it did after its last visit from the regulator.
“We were also honest with the CQC about the challenges that we face”
Meanwhile, it was also rated “requires improvement” for being safe, effective, responsive and well-led, but “good” for being caring.
Inspectors visited the trust’s three main hospital sites, Leicester Royal Infirmary, Leicester General Hospital and The Glenfield Hospital as part of the inspection.
While the trust’s rating had not changed since it previous comprehensive inspection in April 2014, some improvement was found to have taken place, noted the CQC.
Inspectors said they witnessed some outstanding practice, including one ward that held a monthly “posh tea round” so staff and patients could engage socially while enjoying cakes that were not provided during set meal times.
The CQC also noted that the trust’s pain management service had won the national Grünenthal award for pain relief in children in 2016.
However, more work is needed for the trust to “meet the standards people should be able to expect”, said the regulator in its latest report.
Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “Our inspectors found that while some improvement had taken place at the University Hospitals of Leicester NHS Trust further work was needed.
Sir Mike Richards
“The trust cancelled more outpatient appointments than average, resulting in patient dissatisfaction, delays and a clinical need to re-assess some patients,” he said.
“The accident and emergency department experienced challenges which had an impact elsewhere in the trust,” he said. “The department was increasingly busy and patients did not always receive the level of service they should be able to expect.”
He added: “Although we found poor performance during our inspection, the trust recognised it needed to make improvements to how it managed the care of deteriorating patients and sepsis. Evidence we have received since our inspection shows improvement plans are having an impact.”
Professor Richards highlighted that patents were treated with “kindness, dignity and respect”, and that staff commented on the “positive culture change” under the current leadership.
Trust chief executive John Adler said managers had been “honest with the CQC about the challenges that we face”.
“We told them that we are steadily improving quality whilst dealing with large increases in demand, that we were working better with our partners to tackle longstanding strategic issues such as emergency care, and that along the way we were building a more empowered culture,” he said.
Mr Adler said that, overall, he thought the CQC’s current assessment of the trust was “accurate, balanced and fair”.
“We are now in the process of developing an action plan which maps out the improvements we’ll continue to make based on the CQC’s findings,” he said in a statement.
A&E ‘inadequate, chaotic and compromised safety’
Trust chief nurse Julie Smith added: “Throughout the reports were examples of good practice that the CQC had witnessed during their time with us. We are of course proud of these and for the staff for openly sharing them with the inspectors.
“Of course there are areas where we need to improve, which we will be picking up through our action plan which we need to submit by 16 February 2017,” she said.
University Hospitals of Leicester NHS Trust provides specialist and acute hospital services to a population of around one million patients across Leicester, Leicestershire and Rutland.