England’s Chief Inspector of Hospitals has rated services provided by Southport and Ormskirk NHS Trust as unchanged at Requires Improvement overall.
Inspectors visited the trust between 20 November and 7 December 2017. The trust was rated Inadequate for being well-led. It was rated Requires Improvement for safety, effectiveness and responsiveness and Good for caring.
At Southport and Formby District General Hospital the ratings for services stayed the same – Requires Improvement.
Across the hospital patients’ records were not securely stored. In spinal injuries, surgery and medical wards, inspectors found nursing, medical and notes were kept in different places. In urgent and emergency care, surgical wards and the spinal injuries unit, patients’ risk assessments were not consistently completed. This presented a risk to patients.
Across the hospital staff did not follow the trust’s infection control policy in relation to nursing patients with communicable diseases. At the time of the inspection areas within the hospital were not visibly clean. This included areas within spinal injuries, urgent and emergency care, surgery and medical wards.
Since the last inspection, mandatory training levels had improved. Staffing levels and skill mix were planned, implemented and reviewed to keep people safe.
The North West Regional Spinal Injuries Centre is located at Southport and Formby District General Hospital, the overall rating for this service went down to Requires Improvement from Good.
Patient records were not always stored securely in locked trolleys and inspectors noticed patient details were left open on computer screens. Additionally inspectors found there was a lack of security throughout the spinal unit. People who had no business in the unit could freely gain access to all areas and this did not ensure that people were kept safe.
Safety and well-led, within the spinal injuries unit, were both rated Requires Improvement – down from Good since the last inspection in 2016. Caring, effectiveness and responsiveness all remained the same at Good.
At Ormskirk District General Hospital, the rating for services remained the same at Requires Improvement. Inspectors found evidence of under reporting of incidents in surgery services. Staff did not always recognise incidents or report them appropriately.
Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Training had improved on how to recognise and report abuse and staff they knew how to apply it. This has significantly improved since the last inspection.
As part of the urgent care service, CQC inspected the children’s emergency department located in Ormskirk and District General Hospital. The rating for this service remained the same at Good.
Inspectors could see that patient safety and quality improvement were high priorities in the department. Management had identified lessons from incidents and the recent mortality review and were implementing changes to standardise nursing practice.
Mandatory training levels for nursing staff had improved since the last 2016 inspection
Ellen Armistead, Deputy Chief Inspector of Hospitals, North, said:
“Since our last inspection at Southport and Ormskirk NHS Trust, in April 2016, the rating for trust has remained the same at Requires Improvement.
“While we saw some improvements they were limited. Across the trust, urgent and emergency services remained, Good. At the 2016 inspection we raised concerns regarding patients’ privacy and dignity within the department. Unfortunately, at this inspection we observed patients were being cared for on the corridor in various states of condition and undress.
“The North West Regional Spinal Injuries Centre is based at this trust and it’s very disappointing to report that the rating for this service has fallen to Requires Improvement. The service did not have a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community. The service had identified a local strategy; however this was new and relatively undeveloped.
“The pace of change needs to be addressed and the trust remains Requires Improvement overall. It will need to demonstrate it can address all areas that need improvement and sustain the improvements we have reported on.”