The Care Quality Commission (CQC) has rated medical care at Weston General Hospital as ‘requires improvement’ following the results of a new inspection that have been released this week.
The inspection was carried out in August to see whether improvements had been made across the core service at Weston Hospital since the last inspection took place in June 2021 when the service was rated ‘inadequate’.
CQC says the overall rating of medical care at Weston Hospital has improved from ‘inadequate’ to ‘requires improvement’ overall.
It says safety has improved from ‘inadequate’ to ‘requires improvement’. Effectiveness has improved to ‘good’ from ‘requires improvement’, while caring remains ‘good’ and responsiveness remains ‘requires improvement’. Furthermore, how well-led the service is has improved from ‘inadequate’ to ‘good’.
The rating change in medical care doesn’t affect the overall rating of the trust which remains ‘good’. Caring remains ‘outstanding’, effective, responsive and well-led remain ‘good’, and safety remains as ‘requires improvement’.
Catherine Campbell, CQC head of hospital inspection, says: “Following our latest inspection of Medicine at Weston Hospital, part of University Hospitals Bristol and Weston NHS Foundation Trust, we were pleased to see improvements had been made, and standards of care for people as well as their experiences had improved.”
“During the inspection we saw a patient due to be discharged the following day had developed good relationships with those caring for them. The person was clearly very grateful, and a number of nursing and medical staff came to wish the individual well. This was a caring, thoughtful and positive act by staff.”
“Someone using the service told us they had a condition which made drinking more difficult than normal. They told us the drinks they were given were provided in beakers which made drinking easier with less spillages. They also told us cutlery was adapted with foam around the handles to make the grip easier. This is a great example of person-centred care.”
“We found a clear, proactive approach to engaging and communicating with staff regarding the strategy and vision of the hospital. Staff were dedicated to the future direction of the hospital and understood their role in its commitment to be a thriving hospital at the heart of the community, providing the care people need most often.”
“These improvements are testament to the hard work and commitment made by staff and leaders, who have made great strides since our last inspection in June 2021.”
“While the trust recognises there is still work to do, the progress that has been made is extremely encouraging and I look forward to seeing it build on these strong foundations in all other core services provided by the trust.”
The inspection team found staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with other agencies to protect them.
Staff also told inspectors there was a learning culture and they were actively encouraged to report incidents in order to support learning and improvement. Incidents were investigated by ward managers and matrons. However, managers told said they did not always have the time to review incidents quickly.
From August 2021 to August 2022, Weston General Hospital reported 12 serious incidents in medicine. These instances included pressure injuries, treatment delays and medication incidents. It was positive however that inspectors saw the service carried out root cause analyses and patient safety incident investigations into incidents. Actions were identified and shared.
Staff worked collaboratively to make sure there was a continuity of care to patients and make sure the right professionals were involved in care and treatment. Nursing, medical and therapy staff on wards and units worked together to enable care and treatment and to assist patients to improve to go home.
Staff treated patients and those close to them with respect and consideration. Inspectors saw staff lowering their voices and using curtains to maintain confidentiality and dignity when providing patient care.
At this inspection staff were still talking of being tired and working long hours. However, morale had improved since the previous inspection. Staff said there had been a lot of support in the form of services aimed at improving their well-being in the previous 12 months which had really helped with this.
There was a new management team at Weston Hospital who fully understood and managed the priorities and issues the service faced. They were visible and approachable for patients and staff. Staff said they received strong leadership from their direct managers, matrons, and other leaders. Nursing staff said matrons had based themselves on wards to provide additional support to staff, which was appreciated. Medical staff felt the clinical director and medical director were approachable and supportive.
However, inspectors also found: Despite the positive culture which was prominent in the areas CQC looked at on this inspection, there were ongoing concerns around racist behaviours and discrimination against staff who were from ethnic minority backgrounds. Inspectors raised these concerns with the leadership of the trust immediately and were provided reassurance this issue would be tackled as a priority.
Some staff said they often worked excessive hours. Ward managers and matrons in particular worked excessive hours to complete their tasks. They often worked on wards to keep patients safe by ensuring there were enough staff to care for them.
Although staffing levels kept patients safe, this was achieved by moving staff at the beginning of each shift to ensure there was adequate cover across all areas of the hospital. It was also achieved by having ward managers ‘act down’ into roles on the ward. Staff said medical staffing out of hours was stretched, especially at weekends.
The full findings of the reports can be found on the CQC website.
