Today (Wednesday April 12) the Care Quality Commission has published an inspection report on Kettering General Hospital which has given the Trust an overall rating of inadequate.
The report is based on an inspection visit in October 2016 and in the six months since then the hospital has been working hard to make improvements to its services.
The Trust received the inadequate rating because two of our five overall rating categories – safe and well-led – were ranked as inadequate. If a Trust has two inadequate domain scores it automatically receives an overall rating of inadequate.
As a result the CQC has recommended that the Trust be put into special measures which will enable us to receive additional expert support and guidance in tackling our challenges.
The Trust was rated good overall for providing caring services for patients. This was true across all eight services inspected.
Inspectors commented: “All staff were passionate about providing high quality patient care – patients we spoke to described staff as caring and professional.”
In the remaining two categories – providing effective and responsive services – the Trust requires improvement.
Kettering General Hospital’s Director of Nursing and Quality, Leanne Hackshall, said: “We welcome the CQC’s very detailed inspection of the Trust and are disappointed that we did not do better in it.
“We have an improvement plan underway which is addressing the areas highlighted by the CQC. Some actions are already complete and others are in process. Clearly it will take some time to address all of the issues listed in the report and bring them up to standard.”
“Some examples of key improvements we have already made to improve safety and quality are increased staffing levels, improved training programmes, and changes to the hospital’s estate and security arrangements to keep patients safe.”
“Since the October 2016 inspection we have made progress in a number of areas highlighted as needing attention by the CQC:”
“Staffing – The CQC said we needed more staff/or specially trained staff in A&E and more staff generally in the hospital out-of-hours. We have taken on two additional A&E consultants and reviewed our doctor and nurse rotas in A&E – including putting on four additional children’s nurses. We are strengthening out of hours arrangements across the hospital.”
“Children – The CQC said we needed more paediatric trained staff with the right competencies working in A&E and we needed to improve security on the children’s ward and on the post-natal ward. We have taken on more staff and have other new posts pending. We have added CCTV and additional intercom facilities to the children’s ward and are putting similar arrangements in our post natal ward.”
“Waiting times – The CQC said we need to improve waits for routine operations and in the A&E department. We have just completed a comprehensive waiting time improvement programme (March 2017) and are working to improve streaming processes in A&E. We are hampered by having an old A&E department which is under increasing demand and its structure and size is no longer suitable for the numbers of patients attending.”
“Medicines – Our medicines management processes were criticised in terms of compliance with our policies. We are working closely with our ward teams to strongly focus on improved compliance with our policies and procedures. Areas found to have poor compliance have had improvement plans in place with regular reviews.”
“Patient records/care plans – The CQC said they found we did not always fully update patient records and care plans. In response we are revising our care plan documents to make them easier to use and plan to work with NHS England’s Patient Safety Collaborative to do this.”
“Leadership and risk – The CQC was concerned about the way we handle risk, learn from incidents, and how closely our staff follow our processes for maintaining safety. We have taken on a new risk and patient safety managers, and are comprehensively reviewing and improving our systems.”
Kettering General Hospital’s Medical Director, Dr Andrew Chilton, said: “The inspectors found
a significant number of places where we must improve – including some of our processes for managing and recording risk. This was a key factor in our rating because it impacted on our safe and well led domains – which led to our overall rating of inadequate.
“We have already made some changes and are working hard to improve and strengthen our systems and processes.
“I know our staff will be concerned about our rating and they will want to work with their teams to address the concerns raised by the CQC.
“As the CQC has acknowledged patient flow and having enough bed capacity to meet demand is a pressure for us and we are working with our commissioners to tackle this.”
During their inspection the CQC also found areas of good and outstanding practice.
They rated our End of Life and Critical Care services as good and mentioned outstanding practice in a number of areas including our children’s ward play team and chaplaincy.
Kettering General Hospital’s Chairman, Graham Foster said: “We fully acknowledge the scale of concerns raised by the CQC and are rapidly responding to them.
“I want to reassure the public that in most cases our services show good clinical outcomes and patient satisfaction and emphasise that the CQC found our staff caring, passionate and professional.
“We are committed to addressing the issues raised by the CQC but we do also need to address some of the Trust’s underlying demand pressures and resources which do impact on the care we are able to deliver.”