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Staff shortage remains at Colchester as CQC demands urgent action

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Colchester General Hospital has been told it must make rapid improvements on its surgery and medical care inpatient wards after the Care Quality Commission found a series of problems including staffing shortages and poor record completion.

The regulator used its urgent enforcement powers to place conditions on the trust’s registration following an unannounced inspection in July prompted by concerns around staffing, performance and quality of care.

The hospital is run by Colchester Hospital University Foundation Trust, which has been in the CQC’s special measures regime since 2013.

“Administration of medicines on rounds was delayed and this was linked to the staffing levels not being sufficient on the wards”

CQC report on Colchester General Hospital

During this most recent inspection of seven wards at Colchester General, the CQC found staffing levels were not routinely determined by taking into account acuity and dependency of patients.

Instead, staffing ratios were decided on numbers of nurses per patients.

Inspectors warned that while planned nurse staffing levels were met - with the support of agency and bank staff due to low numbers of permanent workers - it found wards with too few staff to meet the needs of patients.

It noted a high use of temporary staff, with some shifts comprising 80% to 100% bank or agency workers.

Meanwhile, the trust failed to show it had an effective system to ensure bank, agency and redeployed staff were inducted and assessed as suitably competent, skilled and experienced to work on the wards, according to inspectors.

Other problems included “poorly completed, disorganised and difficult to navigate” records which “did not provide a clear picture of the care patients required”.

“Agency staff brought in did not always have an effective induction”

Mike Richards

Delays in undertaking patient observations, medicines rounds including providing IV fluids, antibiotics and IV care, were also all noted.

Records for one patient on the emergency assessment unit showed a three-hour delay for receiving medication.

“We observed that the administration of medicines on rounds was delayed and this was linked to the staffing levels not being sufficient on the wards,” said the CQC  in its report on the hospital.

Colchester

Lucy Moore

“Five nurses we spoke with raised concerns about the completion of records by agency staff. They stated that coming on duty following a shift with agency staff was challenging as the records were not well completed,” the report added later.

CQC chief inspector of hospitals Sir Mike Richards said:  “Staffing continues to be a problem. There was not enough staff on the inpatient wards to meet the needs of patients.

“Agency staff brought in did not always have an effective induction and we found that important competency and induction checklists were not available on the wards. In addition, patients at risk of deterioration were not monitored in accordance with trust policy.”

“If, despite all these measures the trust fails to make sufficient progress I have no doubt that we will take further enforcement action to protect the interests of the people who rely on this service,” he added.

Lucy Moore, the trust’s chief executive, said the examples of poor care found by inspectors were “unacceptable” and said the organisation had taken immediate action to address the issues.

She said this included a new ward induction programme for agency and locum staff and a further review of the acuity and dependency needs of patients – resulting in an increase in the number of nursing staff on a number of wards.

“I am confident of the huge effort from all staff to drive improvement, their strong desire and determination to change, and their awareness of the issues and challenges. However, there is more to do to tackle the inconsistency of care that we provide,” said Ms Moore.

The trust was last visited by the CQC in 2014, when inspectors found insufficient staffing levels, poor hygiene and infection control procedures, and nursing staff not always treating patients in a caring way.

  • 3 Comments

Readers' comments (3)

  • It's a shame it takes a scandal for the CQC to open their eyes to issues that have been around at colchester since at least 2005. Fingers crossed for a scandal at ipswich hospital soon, so they too have to make an effort in providing decent working conditions

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  • The NHS is under extreme stress, so many Hospitals have inadequate nursing and medical staff to provide a high standard of care.
    when will the government act to improve nursing care and not introduce extra documentation which removes nurses from performing their basic tasks.
    we work in a blame culture if not ticked it has not happened. Frustrated nurse

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  • Not a Colchester unique problem; this is a problem facing many, if not most Trusts across the country.

    Get more nurses they say. Of course! We didnt think of that! silly us...

    I know, let's start by employing all the nurses that are coming out of nursing courses that have been cut.

    Or maybe scour the earth and fast-track them through our nurse-supportive visa system with the promise of sending them home after 6 years. Genuis.

    Leaving few options - how about more bank or agency nurses? - what? can't do that either?

    I'd like to know where this 'nurse tree' is that the CQC and Mr Hunt think Trusts can magic nurses from.

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