A trust in the South East has increased its staffing levels and re-trained workers in a drive to make changes to its children’s services, following a Care Quality Commission inspection.
Two hospitals under the East Kent Hospitals University NHS Foundation Trust were given an overall rating of “inadequate” for children’s services by the CQC in a report published in October last year.
“We immediately addressed concerns raised by the CQC, including recruiting more specialist children’s staff”
William Harvey Hospital, Ashford and Queen Elizabeth The Queen Mother Hospital, Margate, have since undergone some significant changes and have begun an intensive 12-month improvement programme following the inspection.
The trust said it has taken immediate and thorough action to ensure its hospital services were safe and responsive to the needs of children and young people. It added that the actions included increasing staffing levels, re-training staff, and implementing a new, daily safety checklist.
According to the trust, it has filled a number of vacant posts in both hospitals since the date of inspection, including four children’s nurses, two emergency department children’s nurses, one neonatal nursery nurse, two doctors and two child safeguarding practitioners.
It added that two more children’s nurses would soon be joining the children’s ward at William Harvey Hospital and that it was reviewing the total number of staff allocated to each ward.
In terms of staff training, the trust stated that it had been working to re-train all nurses on early signs of deterioration of children’s symptoms. It had also updated its guidelines for staff on how to monitor sick children to recognise the early signs of a child becoming more unwell.
“Staff have worked quickly and thoroughly over the last three months, changing everyday working practices and how services are managed”
All children’s nurses on the wards, operating theatres and in the emergency department were being retrained with the updated guidelines and new staff will also undertake this training when they begin working there too, noted the trust.
Despite no serious incidents at the hospitals relating to the identification or care of a deteriorating child, it highlighted that the revised guidance and re-training will ensure every member of staff caring for sick children follows the same national procedures and standards.
In addition, new daily safety checklists have been implemented across all hospital areas caring for children and young people, which the trust stated gives full assurance that thorough checks are carried out every day on the fundamentals of care- including medicines storage, cleanliness of equipment and safe medical and nursing staffing.
Following the daily checks, outcomes of the day are discussed at staff “safety huddles” on the wards and clinical departments and action will be taken if necessary. This is also reported to the chief nurse, daily.
Meanwhile, another area which has been improved is the emergency departments for children and young people, in which the trust explains it now has 24/7 nurses available for assessments.
“We were pleased to see improvements within all the areas of children and young people’s services highlighted by the CQC”
Nurses and senior doctors were also reviewing the way children were assessed, diagnosed and treated in emergency departments, in a bid to cut down waiting times.
The trust noted that, following the CQC inspection in October, it reconstructed the organisation from four, large clinical divisions into seven smaller, care groups that were led by clinicians, not managers.
As part of its longer-term measures to improve services as part of the 12-month transformation plan, the trust explained it was working on how it could improve the way its services assess and care for children and young people who are brought to the hospitals to wait for the mental health crisis service.
A focus will also be seen on how to further mental health training for staff caring for these patients and how a more appropriate and private environment for these patients to wait, could be provided.
Also, under the 12-month plan, the trust is investing £250,000 this financial year to redesign and redecorate its oldest children’s ward, Padua Ward at William Harvey Hospital to create a more suitable environment for children’s care.
Trust chief executive Susan Acott said: “Staff have worked quickly and thoroughly over the last three months, changing everyday working practices and how services are managed to make hospital services for children and young people safe and respond to the CQC’s feedback.
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“We immediately addressed concerns raised by the CQC that are highlighted in today’s report, including recruiting more specialist children’s staff, implementing a thorough regime of daily safety checks and improving the environment children are cared for within, particularly in our emergency departments,” she added.
Ms Acott explained how the CQC had announced today that it was “assured” that “significant improvements” have already been made at the trust.
Sarah Vaux, chief nurse of the East Kent Clinical Commissioning Groups, said: “Last week we sent a team to visit the services that the CQC inspected and to see the changes that have been made.”
“We were pleased to see improvements within all the areas of children and young people’s services highlighted by the CQC,” she said.
“Staff talked about the improvements they had made to date and plans for further and continued improvements for families,” said Ms Ascott.