Significant progress has been made at an NHS trust in Kent, but the Care Quality Commission has told the organisation it still requires improvement, including in its triage assessments, mandatory training for nursing staff and documentation of pain.
The CQC visited Maidstone and Tunbridge Wells NHS Trust between October 2017 and February 2018 to assess its urgent and emergency care, medical care, surgery, critical care, and services for children and young people.
“We know we have come a long way since our last inspection and I’d like to thank our staff for their unwavering commitment”
Following the inspection, which took place at Maidstone Hospital and The Tunbridge Wells Hospital at Pembury, the CQC assessed the organisation as “requires improvement”, the same overall rating following its previous visit in 2015.
It found triage was “inconsistent and did not always keep people safe” and that related record-keeping needed improving.
In surgery, not all nursing staff had completed mandatory training in core modules including basic life support, conflict resolution, information governance, moving and handling, medicine management, and dementia awareness.
Patient discharges were also held up in this service due to paperwork delays, meaning people remained in beds when it was not clinically necessary.
In urgent and emergency services, staff failed to always document pain scores for each patient and audits revealed “wide variations in practice,” said the CQC in its report on the trust.
The trust was also told overnight discharges of patients in critical care should be reduced.
However, inspectors highlighted significant improvements, particularly due to changes in how “well-led” the organisation was.
“There are still improvements to be made… in relation to staff training [and] adequate record keeping”
At both hospitals leadership had previously been rated as “inadequate”, but following the most recent visit the CQC said this had improved to “good” at Maidstone Hospital and to “requires improvement” at The Tunbridge Wells Hospital at Pembury.
CQC deputy chief inspector of hospitals, Amanda Stanford, said: “Since our last inspection in 2015 Maidstone and Tunbridge Wells NHS trust has worked to make significant improvements especially in the well-led domain which is reflected in the improved rating.
“Inspectors also identified numerous areas of outstanding practice in four of the core services inspected throughout the trust.”
“There are still improvements to be made, however, in relation to staff training, adequate record keeping, as well as reducing overnight discharges,” she added.
Maidstone and Tunbridge Wells NHS Trust chief executive Miles Scott said the organisation was encouraged inspectors had noted improvements despite a “difficult operational and financial position” in the context of “unprecedented demand across the NHS as a whole”.
“We know we have come a long way since our last inspection and I’d like to thank our staff for their unwavering commitment to their patients and the trust. During their visits, the CQC inspectors praised staff on numerous occasions for their friendly and welcoming attitudes, and their shared vision and engagement,” he said.
“Our top priority will always be to provide best possible service to our patients and we look forward to working with the CQC in the future to build on the strong foundations already in place, to continually strive for improvement across all areas,” he added.