CQC warns Mid and South Essex NHS Trust over failings

Inspectors said Southend Hospital did not have enough medical staff with the right qualifications, skills and training

Medical care at three Essex hospitals has deteriorated, inspectors have found.

The Care Quality Commission (CQC) visited Basildon, Southend and Broomfield hospitals after being alerted to safety concerns.

The Mid and South Essex NHS Foundation Trust has been given a warning by the CQC demanding immediate improvements.

Acting chief executive Hannah Coffey described the report as "hugely disappointing".

All three hospitals have been rated "inadequate" for medical care, having previously been graded "requires improvement".

Southend did not have enough medical staff with "the right qualifications, skills, training and experience to keep patients safe from avoidable harm", the inspection report said.

Inspectors found catheter bags touching the floor, putting patients at risk of urinary tract infections.

They also discovered a frail elderly patient in urine soaked sheets who was in pain, but could not alert staff because the call bell was out of reach.

Leaking pipes

At Broomfield there were high vacancy rates and not enough nursing and support staff, according to the CQC.

Leaking and damaged pipes were discovered at Basildon Hospital while a patient was being nursed in the room, despite the problem being reported three weeks previously.

Checks on 14 "Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)" documents revealed half the patients concerned lacked capacity but only two had been assessed under the Mental Capacity Act, inspectors found.

DNACPR is the guidance for when a person has a cardiac arrest or dies suddenly governing what action should or should not be taken by medical staff.

"This meant that appropriate actions were not always identified to protect patients from avoidable harm," they said.

Other findings across all three hospitals included:

• People could not access the service when they needed it

• Waiting times did not always meet national standards

• Staff did not always complete and update risk assessments

• Staff did not always keep detailed records of people's care and treatment

Mid and South Essex NHS Foundation Trust as a whole remains rated as "requires improvement".

Broomfield Hospital has also been downgraded to 'inadequate'

However, across all three services people were treated with compassion and kindness, the CQC found, and patients' individual needs were supported.

All three hospitals were merged into a single trust in April 2020.

Hazel Roberts, CQC deputy director in the East of England, said its leadership did not have complete oversight of the issues they were facing.

"We want to see significant improvements," she said, adding they should "make sure people are able to access the service when they need it, and that there are enough trained staff to care for them safely".

'Getting the basics right'

Acting trust chief executive Hannah Coffey said an action plan was in place to drive improvements

The acting chief executive of Mid and South Essex NHS Foundation Trust, Hannah Coffey, said work was already under way to address the issues raised.

"We are an organisation committed to quality improvement and to providing the best possible care for our patients," she said.

Ms Coffey added that the algorithm used by the CQC meant they had now rated Broomfield and Basildon hospitals "inadequate" overall.

"When we merged to become one organisation, the previous ratings for Basildon and Broomfield were erased, meaning that only a very small number of services on those sites have been inspected. This has had an impact on their overall rating," she said.

It is understood the formula incorporates older ratings which in this case were only applied to Southend because it was the 'acquiring' trust during the merger.

This meant that ratings for Basildon and Broomfield prior to the merger were discounted.

"There has been a real focus on getting the basics right" added Ms Coffey.

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