The Care Quality Commission (CQC) has this week told Weston Area Health NHS Trust that it must make more improvements in its emergency department services following its latest inspection.
CQC says it undertook an unannounced inspection in September 2019 in response to concerns identified in a warning notice issued to the trust.
This referred to the safety and quality of patients’ care in the urgent and emergency care department and specialist Community Mental Health services for children and young people (CAMHS).
The warning notice set out the following areas of concern, where significant improvement was required by 5 July 2019 in urgent & emergency care, and Community Mental Health services for children and young people.
After the inspection CQC confirmed the trust had met the requirements of the warning notice for specialist Community Mental Health services for children and young people, however there was further work to be done in urgent and emergency care.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals in the South, says: “It is disappointing to report that since our original inspection Weston Area Health NHS Trust has not made enough progress to fully satisfy our warning notice.”
“Although we have seen real improvements in their CAMHS services, we have made it clear that we require further work to address the issues we had found in urgent and emergency services.”
“We told the trust where it must take action to improve. The trust leadership has assured us that board are fully sighted on the issues we have raised.”
“Weston needs to sustain the improvement we have found and address the issues which we have again identified. We will return in due course to ensure that the necessary improvements have been made.”
In urgency and emergency, the care inspectors found governance systems were still not operating effectively and they say there was no structured training plan or system of staff supervision.
Junior doctors were positive about the support and supervision they received, though there were still some concerns, particularly about support at weekends. But, there had been efforts to make improvements. There was now a positive “can do” attitude among senior staff. Systems had been reviewed and strengthened and a new governance lead for the emergency department had been appointed. Improvement meetings had been set up.
In CAMHS the trust had recruited a clinical nurse lead to take charge of clinical activity within the team. This included waiting lists, supervision and training. Managers had ensured the service was fully recruited. Temporary staff had also been recruited to help reduce waiting times. The time young people were waiting between assessment and referral had also reduced.
Managers were aware of incidents when they happened. They were also able to give inspectors examples of how practice had changed to prevent incidents reoccurring. There was evidence that managers were more engaged in learning from incidents than they were at the previous inspection.
