Saturday 3 February 2018

It's OK, they bought an APP!

The Care Quality Commission, which is supposed to police quality at NHS Hospitals, made an annanouced inspection At St. Peter's back in September and 'Get Surrey' has reported on the visit.

But it's OK - the Hospital bought an APP, so everything's alright.



St Peter's Hospital inspection lists catalogue of failures including blocked fire doors, unsecured medication and infection risks
 
The Care Quality Commission made an unannounced visit to the Chertsey hospital in September last year.

By

Zosia Eyres,

 11 JAN 2018

Despite praise for its "compassionate" staff, a catalogue of failings was documented during the latest inspection of St Peter's Hospital .

 

Blocked fire exits, unsecured medication, infection risks and potentially unreliable emergency equipment were all spotted at the Chertsey hospital by the Care Quality Commission (CQC).
The unannounced visit on September 19 last year was focused on nursing care on the medical wards after the CQC said it received "information of concern".

Although Get Surrey reported that the hospital had 460 unfilled posts in November  , inspectors were "satisfied that staffing was planned and numbers of staff and skill mix were of a satisfactory standard" on the day of the visit.
However, the CQC report, published on Tuesday (January 9), reveals that 40% of staff on the acute care Aspen ward were "not up to date with mandatory training".

During the visit, a suction catheter was seen lying on the floor, stained scissors were found in the wrong place, the utility room was dirty - and contained six bags of used disposable bedpans - and paint was peeling, posing an infection risk.

Furthermore, inspectors judged that a lack of consistency in the availability of equipment, for example there was no oxygen mask between two beds, "presented a risk of confusing or delaying staff responding to an emergency".

In terms of equipment, a resuscitation trolley was found to not have the suction tubing attached, which meant it was "not ready for use in an emergency". And an automatic defibrillator had not been tested regularly in line with policy, meaning that it "might not function in an emergency 
Medicine storage was found to be "not secure" on two wards; the report describes how on Cherry ward, the clinical room where medicines were stored had a key pad but at the time of inspection the key pad was fixed open and the room was not secure.

On Swift ward further drug cupboards and a drug trolley were found unlocked - and the medicine fridge temperature was not checked on two days during the week before the inspection.
A number of blocked - and one broken - fire exits were noted, including one which had a chair behind it which "could act as a source of fuel in a fire". Following the CQC's visit an email was sent out reminding staff of fire safety and a commitment was made to complete a fire audit check across the hospital.

However, despite these failings, patients spoken to "across all ward areas were positive about the care they had received".
One patient told inspectors that staff "understood their condition" and described them as "very good and compassionate".

The CQC spoke to employees about their experience at the hospital and was told that the atmosphere was "open and transparent" and that they felt "supported by the senior staff".
Good practice was additionally noted with regards to "the strategy and initiatives to prevent and monitor pressure ulcers", as well as "the planning and delivery of nursing care".

Following the visit, the CQC gave the hospital a list of things that it must and should improve.

Chief nurse at St Peter's, Sue Tranka, said: “We are always very open to visits by the CQC and welcome their feedback and report. Whilst we recognise there are areas for improvement, we were encouraged to see many good areas of practice noted by the inspectors."

The Care Quality Commission's conclusions
Action the hospital MUST take to improve:

The trust must ensure that all fire exits are kept clear and ward staff are aware of their responsibility to maintain this.
The trust must ensure the safe storage and security of medicines.

The trust must ensure safety checks and services on patient equipment are consistently completed.
 
Action the hospital SHOULD take to improve

Support and enable all staff to complete mandatory training

• Continue its strategy to make safety thermometer information more accessible to staff and patients.

Responding to the concerns raised, nurse Tranka said the identified issues are "not widespread problems across the hospitals".

 She explained that an 'e-checklist' had been piloted since the visit; this creates a daily list of the top ten issues raised by the CQC to be completed by the senior nurse leader.

Nurse Tranka said: "The app has been really successful, so our challenge going into this year is how we embed this good practice across our other wards.

"With regards to our mandatory training, the report refers to us not reaching our target of 90% of staff being up-to-date with their training requirements. 
"This is an ambitious target (which recognises the importance of this training) and last year we achieved 81% - which benchmarks well against other local acute trusts.


"When our hospitals are very busy we need to prioritise the needs of our patients and training sessions do get pushed back.

"We need to find ways to make training more accessible – such as e-learning modules – and we will be focusing on that this year.” 

As it was a focused inspection, the hospital's overall 'Requires improvement' rating from its 2015 report was not changed.
 
Neil Harris
(a don't stop till you drop production)
 

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