Following an inspection of four services at Kettering General Hospital 6 months ago, the Care Quality Commission (CQC) has told Kettering General Hospital NHS Foundation Trust that it must make improvements.
The Role of the CQC
CQC is the independent regulator of health and adult social care in England.
They make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.
They do this by monitoring, inspecting, and regulating services and publishing their findings. Where they find poor care, the CQC will use their powers to take action.
Following any inspection, in most cases, the CQC will provide a rating for the service they have inspected.
1. Outstanding – the service is performing exceptionally well.
2. Good – the service is performing well and meeting our expectations.
3. Requires improvement – the service isn’t performing as well as it should and the CQC have told the service how it must improve.
4. Inadequate – the service is performing badly, and the CQC have taken enforcement action against the provider of the service.
Inspection findings at Kettering
The CQC carried out an unannounced inspection following information of concern regarding the safety and quality of medical care and surgery services at the Trust.
The four inspected services were children and young people’s services, urgent and emergency care, medical care, and surgery.
The inspectors visited various areas relevant to each of the core services and spoke with 167 staff members of various roles across different specialities, along with 48 patients, and 22 relatives, carers, and parents.
Overall, following the inspection, these were rated as follows:
- Children and young people’s services: Requires Improvement
- Urgent and emergency care: Requires Improvement
- Medical care: Requires Improvement
- Surgery: Requires Improvement
In urgent and emergency services at the Trust, the CQC’s inspectors found:
- There wasn’t a consistent process for staff to follow to assess people being brought in by ambulance.
- Staff described a culture of learning from incidents in the department, while others described a culture of blame where staff didn’t acknowledge or talk about their mistakes for fear of ridicule.
- People presenting with acute mental health concerns didn’t have access to a dedicated room which met national guidance relating to the provision of a safe environment.
In medical care, inspectors found:
- The service didn’t always have enough nursing and support staff to keep patients safe.
- Staff didn’t always make sure the needs of people with a learning disability or autistic people were assessed to ensure they were provided with person centred care.
In surgery, inspectors found:
- Staff said they felt staffing levels were insufficient and that this added extra pressure to ensuring safe care.
- Staff were concerned that people were not always assessed by senior medical staff when they were showing signs of deterioration.
CQC Deputy Director of Operations in the Midlands, Charlotte Rudge, said:
“When we inspected Kettering General Hospital NHS Foundation Trust, we saw that the quality of leadership had declined which was having an impact on the quality of services. Although we saw some improvement in children and young people’s services, there is still much more to do there and across medical, surgery, and urgent and emergency services.
We saw several issues with the urgent and emergency service environment which could be a potential risk to people’s safety. It was clear the demand on the service had outgrown the size of the department and we saw people sitting on floors or standing due to insufficient space. Sometimes, relatives had to alert staff to people’s conditions deteriorating due to nurses not being able to see everyone in the waiting area which was placing people at the risk of harm.
In addition, the children’s waiting area wasn’t always separated from the adults. We heard examples where children had witnessed high risk patients being treated which could have been traumatic for them.
However, it was positive that some improvements had been made at children and young people’s services. Staff were better at identifying sepsis and there was clear evidence of timely escalation to the medical team once someone had shown symptoms…
…We will continue to monitor the Trust, including through future inspections, to ensure the necessary improvements are made so people can receive safe and appropriate care.”
You can read the full CQC report here.
Comment
The overarching theme of the findings of the CQC at Kettering is clearly a lack of patient safety.
It is unacceptable that patients utilising the services of this Trust are potentially being put at risk of harm and clearly further significant improvements are urgently needed.
Every patient has the right to expect safe care when they go into hospital and, above all, patient safety is key to avoiding unnecessary harm.
The Trust must take heed of the warnings from the CQC and take action to make the necessary improvements as soon as possible.
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Danielle Young is a Legal Director in our Medical Negligence team, which is ranked in Tier One by the independently researched publication, The Legal 500, and Commended in The Times Best Law Firms 2024.
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