Emergency care at Countess of Chester 'inadequate'

Inspectors have graded the emergency services department at the Countess of Chester Hospital as 'inadequate'.

An unannounced inspection of the urgent and emergency services department by the Care Quality Commission (CQC) earlier this year found improvements needed to be made in safeguarding, as well as in the safety of premises and equipment.

Inspectors for the health watchdog found repeated breaches of legal regulations in five areas, and have subsequently issued a warning notice to the hospital trust calling for "rapid improvements".

The Trust said it was disappointed by the rating and had taken immediate action following the CQC's recommendations.

Breaches in regulation

The inspection was carried out in February, in response to concerns regarding the access, flow and care of people with mental health issues attending A&E, as well as how people are cared for in non-clinical areas such as the corridors.

The CQC said some of the concerns raised were substantiated by their inspection.

In addition, inspectors found previous concerns regarding the cleanliness of the department and the regular testing of equipment to make sure it was safe, had not been addressed.

Karen Knapton, CQC deputy director of operations in the north, said there were ongoing issues over how the department managed the flow of patients within A&E and on to the wards.

Inspectors found poor practice slowed down the discharge process and led to "significant delays" in those who were waiting receiving treatment, with their conditions sometimes deteriorating as a result.

"People were sometimes held in ambulances for prolonged periods of time due to this limited capacity in the department," said Ms Knapton.

"We also saw someone with suspected sepsis not receiving treatment according to national guidance, placing them at risk of harm."

She said gaps in staffing cover, "combined with a very busy department", meant people being cared for in corridor beds "had become normalised".

A warning notice was issued due to breaches of five of the legal regulations in relation to: dignity and respect, safeguarding from abuse and improper treatment, premises and equipment, governance, and staffing.

However, inspectors found the department demonstrated a strong commitment to learning, improvement, and staff wellbeing, and said staff were encouraged to report incidents.

'Long-standing challenges'

"We have told leaders where we expect to see rapid improvements and will continue to monitor the service closely," Ms Knapton said.

The trust has received £7.5m since the inspection in February, to help implement improvements.

Jane Tomkinson, Chief Executive Officer of the Countess of Chester Hospital NHS Foundation Trust, said: "Our focus remains on addressing some long-standing challenges, and we are committed to supporting our teams to ensure that the actions we take lead to sustainable improvements in our services.

"We will continue to work closely with our regulators, and we anticipate a further inspection in due course where the improvements will be demonstrated."

The overall rating for Countess of Chester Hospital NHS Foundation Trust remains as 'requires improvement'.