CQC demands urgent improvements at Mid and South Essex NHS Foundation Trust
It found deterioration in the quality of medical care
Last updated 16th Jun 2023
The Care Quality Commission (CQC) has told Mid and South Essex NHS Foundation Trust that urgent improvements are needed, after a report found deteriorations of their medical care at all three of their hospitals.
Inspections took place at the Southend University Hospital, Broomfield Hospital and Basildon University Hospital, in January and February, after concerns were raised about the safety and quality of services of medical care and older people's services.
That included people’s nutrition, hydration, pressure area care and the management of risks.
The CQC served the trust with a warning notice, requiring them to make immediate changes to ensure services are safe.
Mid and South Essex NHS Foundation Trust provided the CQC with an action plan, outlining how they intended to address the areas of concern highlighted in the warning notice.
There were also positives in the report, with inspectors noting that staff worked well together to provide compassionate care for patients and their families.
People’s individual needs were supported, and staff helped patients to understand their conditions. Staff also provided emotional support to patients and their loved ones.
What did the report find?
Findings from all three locations included:
• The premises and equipment along with the upkeep did not always keep people safe.
• The service did not always have enough nursing and support staff.
• People’s dignity and privacy was not always respected by staff.
• People could not access the service when they needed it.
• Waiting times from referral to treatment and arrangements to admit and treat people did not always meet national standards.
• People were not always safe because staff did not always complete and update risk assessments for each person to remove or minimise risk.
• Staff did not always keep detailed records of people’s care and treatment.
However,
• People were treated with compassion and kindness.
• People’s individual needs were supported, and staff helped them understand their conditions. Staff also provided emotional support to people and their loved ones.
What's the rating of the hospitals now?
The overall rating of both Basildon Hospital and Broomfield Hospital have been affected by the inspection of medical care, dropping them from requires improvement to inadequate.
That also includes the dropping of ratings for safe, effective and well led.
Southend Hospital remains rated as requires improvement.
Mid and South Essex NHS Foundation Trust remains rated as requires improvement overall.
Hazel Roberts, CQC deputy director in the east of England, said:
“Following our inspection of medical care at the Mid and South Essex NHS Foundation Trust we found a leadership team who didn’t have complete oversight of the issues they're facing.
“We've highlighted a number of issues where they need to have far better oversight and where we want to see significant improvements. This includes making sure people are able to access the service when they need it, and that there are enough, trained staff to care for them safely.
“Leaders need to ensure they are allowing staff the time to complete essential training, including safeguarding and conflict resolution. This helps staff to understand and look out for risks and how to deal with them. Without this training, staff weren’t always able to complete and update risk assessments for each person to remove or minimise these risks.
“It was also disappointing that people’s privacy and dignity wasn’t always respected. We found areas in all three hospitals where a ward at full capacity didn’t have curtains or screens to provide privacy and dignity to every person occupying a bed.
“During the inspection we did see staff mostly treating people kindly and with care. However, we also saw in some areas, staff didn’t always support people to make informed decisions about their care and treatment. Especially when the person lacked capacity to make their own decisions or was experiencing a severe mental health crisis.
“We are aware the local integrated care system is supporting the trust, as are NHS England and they should use this additional expertise and resource to make the rapid improvements that we need to see. Leaders also need to listen to staff who are in the best position to help implement the changes needed to ensure these improvements are embedded.
“we have fed back our findings to the trust leadership team who were fully aware of what they need to do to make and embed the improvements needed. We will re-inspect to ensure improvements are being made and won’t hesitate to take further action if needed to protect people.”
Hannah Coffey, Acting Chief Executive of Mid and South Essex NHS Foundation Trust, said:
“This is a hugely disappointing report. Work is already well underway to address the issues raised, and that was recognised by the inspectors.
“We are an organisation committed to quality improvement, and to providing the best possible care for our patients.
“We are disappointed that, while there are no other services apart from medicine rated as inadequate at any of our hospital sites, the algorithm used by the CQC means that they have now rated Broomfield and Basildon Hospitals as inadequate overall.
“When we merged to become one organisation, the previous ratings for Basildon and Broomfield were erased meaning that only a very small number of services on those sites have been inspected. This has had an impact on their overall rating.
“We know that there is more to do to make sure we are getting it right for every patient, every time. But we have dedicated, hard-working staff who are pulling out all the stops to ensure we provide excellent care to those who need it.
“In the five months since we were inspected, significant improvements have been made to inpatient environments and we are supporting nutrition and hydration by recruiting more feeding buddies to work with patients at mealtimes. We have also introduced a Nutrition Charter for patients and brought in protected mealtimes.
“There has been a real focus on getting the basics right – which is already leading to improvements in care.
“We are offering personalised training for our staff, and have seen a significant reduction in staff vacancies and turnover.”
Hannah said: “We know we have a lot to do to improve the ratings for medical services and are absolutely committed to this work. We are very clear about what needs to be done and confident we can build on the positive changes already made to get the basics right every time, for every patient.”