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<\/p>\nTHE Care Quality Commission (CQC) has again rated The Princess Alexandra Hospital requires improvement, following an inspection of its medical care services, surgery services, and urgent and emergency services in November.<\/p>\n
<\/p>\n
The Princess Alexandra Hospital is run by The Princess Alexandra Hospital NHS Trust. This inspection did not affect the ratings for the trust as a whole. CQC recently inspected the leadership of the trust and these findings will be published separately in due course.<\/p>\n
This inspection was carried out both as part of CQC\u2019s routine monitoring of health and care services and in response to some risks people raised.<\/p>\n
CQC has raised the hospital\u2019s rating for medical care from requires improvement to good overall. CQC raised medical care\u2019s ratings for effective and well-led from requires improvement to good. CQC again rated these services good for caring and responsive, but requires improvement for safe.<\/p>\n
CQC has again rated the hospital\u2019s urgent and emergency services requires improvement overall. It again rated them requires improvement for safe and well-led. <\/p>\n
It downgraded them from good to requires improvement for caring. <\/p>\n
It again rated them good for effective. It raised their rating for responsive from requires improvement to good.<\/p>\n
CQC has lowered the hospital\u2019s surgery services from good to requires improvement overall. <\/p>\n
CQC again rated them requires improvement for safe and lowered them from good to requires improvement for well-led. <\/p>\n
It again rated them good for effective, caring, and responsive.<\/p>\n
Based on the change in ratings for these three services, CQC has again rated the hospital requires improvement. <\/p>\n
CQC again rated it requires improvement for safe, responsive, and well-led, and again rated it good for caring. CQC raised it from requires improvement to good for effective.<\/p>\n
CQC has requested action plans from the trust to address the most pressing concerns found, and the trust has acted immediately to make improvements.<\/p>\n
Sarah Ivory-Donnelly, CQC deputy director of hospitals in the east of England, said:<\/p>\n
\u201cWe found shortfalls in people\u2019s safety across all three services that we inspected at Princess Alexandra Hospital. <\/p>\n
Leaders had identified most of these themselves, but were addressing them with varying degrees of success.<\/p>\n
\u201cWhile leaders on the medical wards were making improvements proactively and successfully, we found leaders in the surgery and emergency services hadn\u2019t always supported or sustained improvements as well as they could.<\/p>\n
\u201cWe found staff on the surgery wards weren\u2019t completing all risk assessments consistently, and some handovers between staff were poor. This created opportunities for information to slip through the cracks, which could impact people\u2019s safety and the effectiveness of their treatment.<\/p>\n
\u201cThere was still intense pressure on the emergency department, stemming from high demand, poor flow and, temporarily, an ongoing refurbishment of the building. <\/p>\n
This created some long waits and crowding during times of high demand, impacting people\u2019s privacy and quality of care. <\/p>\n
This was particularly impactful on people waiting for mental health care from other organisations, as the department didn\u2019t always have enough facilities or mental health staff for them to wait safely and comfortably.<\/p>\n
\u201cIt was clear that frontline staff across all three services were trying hard to mitigate risks and offer people the best care they could in difficult circumstances. People told us many times that staff were kind, respectful, and helped them understand their treatment. Leaders were quick to respond when we raised our concerns to them.<\/p>\n
\u201cWe\u2019ve shared our findings with the trust so they know where improvements must be made, and where there is good practice to build on. We continue to monitor these services very closely to ensure people remain safe in the meantime and will follow up on their progress.\u201d<\/p>\n
Inspectors also found:<\/p>\n
Staff didn\u2019t always manage medications safely. Some emergency medications were expired or missing in the emergency department (ED), and some medicines had been stored on the floor in the medical wards.<\/p>\n
Staff in the ED weren\u2019t always monitoring people closely enough, particularly in temporary care areas, to quickly identify deteriorations in their health.<\/p>\n
While most areas were clean, some staff didn\u2019t always follow best practice to control infection risks, such as washing their hands between caring for people.<\/p>\n
The trust didn\u2019t always ensure environments were safe. Inspectors found obstructed fire exits and incorrectly stored oxygen on the surgery wards.<\/p>\n
Leaders encouraged feedback from staff and the people using their services. However, they didn\u2019t ensure people in the ED had opportunities to raise concerns about their care in the moment, to address immediate issues.<\/p>\n
Leaders didn\u2019t ensure there were always enough staff to meet people\u2019s needs comfortably. They mitigated risks from this by redeploying staff when needed.<\/p>\n
However:<\/p>\n
Staff treated people as individuals, involved them in care planning as much as possible, and respected their preferences and consent.<\/p>\n
Staff provided people evidence-based treatments that met good practice standards.<\/p>\n
Staff on the medical wards worked particularly well with each other and other services to meet people\u2019s needs and discharge them in a timely way.<\/p>\n
The report will be published on CQC\u2019s website in the coming days.<\/p>\n
YH has approached PAH for a comment.<\/p>\n
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