New Report Upgrades Charing Cross Hospital Medical Care to 'Good'
But Care Quality Commission says Hammersmith still 'requires improvement'
The reports follow an inspection which took place in March 2017. It looked at medical care at Charing Cross in Hammersmith and Hammersmith Hospital in Shepherd's Bush as well as St Mary’s hospitals in Paddington. These services were last inspected in September 2014.
While Charing Cross' medical care was rated "good" - up from "requires improvement" in 2014, Hammersmith Hospital was still rated "requires improvement" as it was in 2014.
The Care Quality Commission said of Charing Cross:
Medical care (including older people’s care) at Charing Cross Hospital was rated Good overall by CQC. For being effective and caring it was rated Outstanding. For being responsive and well-led it was rated Good and for being safe it was rated Requires Improvement.
CQC last inspected the medicine and elderly care service in September 2014 as part of our comprehensive inspection
programme and rated the service as Requires Improvement.
Key findings included:
All staff were actively engaged in activities to monitor and improve qualities and outcomes.
The hospital was the second best performing hospital in the
country among the trusts taking part in the Sentinel Stroke National Audit Programme (SSNAP) for the hyper acute stroke unit.
The trust was consistently monitoring and improving their mortality rate and remained in the top five lowest-risk acute trust.
There was a strong, caring and visible-centred culture, which was fully rooted on all the medical wards visited. Staff inspectors spoke to were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
The service provided care that took account of people’s personal, cultural, social and religious needs. Patients and relatives gave positive feedback about the manner and attitude of staff. During inspection people were treatment with kindness and respect by staff from all disciplines.
However, staff did not follow the trust policies and national guidelines in the management and disposal of medicines, including controlled drugs and medical gases. Mandatory training rates for scientific and technical staff (31.4%) were significantly lower than the trust’s 90% target. There was a high usage of nursing bank and agency staff due to the high number of vacancies.
The trust needs to make some improvements. It must:
Make sure that staff follow the trust’s medicine management policies concerning safe storage of medicines and medical gases.
Take action to ensure medical wards are meeting mandatory training including the resuscitation training requirements for staff.
Of Hammersmith Hospital, it says:
CQC last inspected the medicine and elderly care service in September 2014 and rated the service as Requires Improvement.
During this latest inspection inspectors found the overall quality of the medicine and elderly care services had stayed the same, but there were some positive changes. The service was rated as Requires Improvement overall. Being safe and responsive were rated as Requires Improvement, while being effective, caring, and well-led were rated as Good.
CQC’s key findings included:
Signage on site was poor and therefore, there were many visitors and members of the public lost and wondering how to get to their desired location.
The environment on some wards was poor. Staff submitted requests for repairs but the work took a long time to be carried out.
Liquid medicines on two wards did not have a date recorded for when they were opened. One of those medicines was used to relieve severe pain and should be used within 90 days of opening.
The results of the national diabetes audit showed patient experience was rated below the national average and the rate of foot assessments was worse than other services.
Patients could not access the patient advice and liaison service at Hammersmith Hospital. The service was advertised as being available but the office was closed and the telephone number provided was not manned.
The trust must now:
Ensure all wards and departments follow the trust’s medicine management policies so that medicines are safe for administration to patients. In particular for date checking medicines and storing medicines in refrigerators.
Improve the proportion of medical staff completing mandatory training, level 2 adult safeguarding training in particular.
England’s Chief Inspector of Hospitals, Professor Ted Baker, said:“We saw several areas of outstanding practice at Charing Cross Hospital. Without exception, patients told us they were treated with kindness, dignity, respect and compassion. There was a high standard of care provided for patients on the medical wards, and we saw that staff went to great lengths to respect and accommodate the wishes of patients and their loved ones.
"There was a strong, caring and visible-centred culture, which was fully rooted on all the medical wards visited. Staff we spoke to were highly motivated and inspired to offer care that was kind, respectful and promotes people’s dignity. Staff consistently considered people’s personal, cultural, social and religious needs and delivered kind and compassionate care."
"At Hammersmith Hospitals staff told us patient transport between sites was a problem and patients were unhappy about the length of time they waited for transport between sites and for going home after treatment. Staff told us executive directors did not often visit the site.
"However, the service managed patient safety incidents well. Staff received feedback from incidents they had reported. Learning from incidents was included in a staff bulletin, which was circulated to staff in the medicine and integrated care division. Results of patient safety monitoring were displayed on ward noticeboards for patients and visitors.
You can read these reports, plus the report on St Mary's Hospital in full on the Quality Care Commission's website.
Imperial College HealthcareNHS Trust chief executive Ian Dalton CBE said: “While there are some very clear priorities for improvement, there is also much that is positive to build on. The CQC acknowledged improvements in medicine across all of our sites since the last inspection, sufficiently so at Charing Cross to increase our rating there to good.
"Given the challenges of our old estate, an ambitious cost improvement programme and increasing urgent and emergency demand, the inspection findings reflect a tremendous amount of hard work and commitment from our staff. The teams are already focusing on pulling together a robust action plan to address the findings of the CQC as quickly as possible."
October 26, 2017
