Why North Devon Hospital 'requires improvement' after damning inspection
Concerns have been raised by inspectors, who've formally told a Devon Hospital they need more staff.
The Care Quality Commission has told Northern Devon Healthcare NHS Trust to improve staffing levels in the medical care service at North Devon District Hospital 'to ensure the safe care and treatment of patients'.
Inspectors found 'there was a shortage of medical and nursing staff which meant patient safety was not always maintained', 'staff identified patients at risk of deterioration but they did not always provide care in a timely manner' and 'in some cases, patients were admitted onto medical wards which were not designed or equipped to deal with their specific illness or needs'.
The report also found: "Sometimes staff did not report near misses, as they were not aware it was their responsibility to do so. This meant that the opportunity to learn from incidents and near misses was often lost."
Inspectors also warned: "Care records were not always complete and/or legible. Medicines were not always well managed."
Following the inspection, the overall rating for medical care services went down from 'good' to 'requires improvement' and the ratings for 'safe, effective and well-led' also went down from 'good' to 'requires improvement'. The service retained its rating of 'outstanding' for 'being caring' and the rating for 'responsive' also remained as 'good'.
Dan Thorogood is Inspection Manager for the Care Quality Commission
This inspection did not change the overall rating for the hospital which is 'requires improvement'.
Cath Campbell, CQC’s head of hospital inspection, said: “When we inspected the medical care services at North Devon District Hospital, we found a high number of vacancies with a reliance on agency staff, and not addressing issues around the availability and responsiveness of medical staff for deteriorating patients. This put patients at risk of harm.
“Although nursing staff were quick to identify and act when they spotted patients who were at risk of deteriorating, medical staff did not always attend to these patients quickly. We saw two patients waiting an hour or more for the doctor to assess them and administer appropriate treatment.
“There were also occasions when doctors did not respond when paged by the nursing staff, forcing them to contact the intensive care unit to request one of their doctors to urgently review a patient who had deteriorated.
“It was also very concerning to hear a few staff were labelled negatively by their managers for reporting too many incidents. This was preventing other staff from coming forward to report incidents, especially in relation to being short staffed. Staff told us they were sometimes too busy to report incidents and felt little was done about them anyway.
“That said, the medical care services team is thoroughly deserving of its outstanding rating for being caring, which it retained following this inspection. The service introduced a number of commendable new initiatives to reduce patients’ anxiety during the COVID-19 pandemic.
“We have told the trust it must address the medical staffing issues as a priority, and it has assured us it is working hard to do so. As well as recruiting new staff, it has been working with another neighbouring trust to support care provision at the hospital.
“We have also told the trust to ensure the service responds appropriately and quickly when patients are deteriorating, and that staff are encouraged to report all incidents, including near misses. We will keep a close eye on progress and will return to ensure the required improvements are made.”
In response Suzanne Tracey, chief executive officer for NDHT and RD&E, said: “We are not surprised by the CQC’s findings. We have fantastic, caring and compassionate teams in Northern Devon and clear strengths in the acute medicine service, but NDHT is undoubtedly in a very challenging position when it comes to recruiting medical staff to fill our vacancies.
“This is why NDHT sought the support of RD&E through the collaborative agreement to help address the inequity of care for people in Northern Devon due to staffing shortages.”
“Increasing our staffing numbers through recruitment will only be part of the solution – we need to develop a joint model of care to meet the rising demand we are facing across Devon, which makes the best use of digital opportunities, with a focus on ensuring patients get the best possible outcome across all areas we serve.”
"More information about the proposed integration is available here. We will continue to provide updates throughout the process."
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