The Care Quality Commission (CQC) has found improvements in the care being provided in services run by The Shrewsbury and Telford Hospital NHS Trust following inspections in October and November. These latest inspections see the overall rating for the trust improve from inadequate to requires improvement.
In October an unannounced inspection was carried out of end-of-life care, medical care (including older people’s services) and urgent and emergency services at the Royal Shrewsbury Hospital.
An inspection was also carried out of children and young people’s services, end of life care, maternity, medical care (including older people’s services) and urgent and emergency services at the Princess Royal Hospital.
CQC inspected these services to check whether improvements had been made to the care and treatment being delivered, following concerns identified at the previous inspection.
An inspection of how well-led the trust was overall, was also carried out in November.
Following these inspections, as well as the overall rating for the trust improving from inadequate to requires improvement, as have their overall ratings for being safe and responsive. Caring has improved from requires improvement to good. Being effective and well-led have been re-rated as requires improvement.
The following services were rated:
- Children and young people’s services at the Princess Royal Hospital – this has improved from inadequate to good overall
- Maternity at the Princess Royal Hospital – overall has improved from requires improvement to good
- Medical care (including older people’s care) at the Princess Royal Hospital – has been re-rated as requires improvement overall
- Urgent and emergency care at the Princess Royal Hospital – overall has declined from requires improvement to inadequate
- Urgent and emergency care at Royal Shrewsbury Hospital – overall has improved from inadequate to requires improvement
- Medical care (including older people’s care) at Royal Shrewsbury Hospital – overall has again been re-rated as requires improvement
- End of life care at both hospitals - has improved from inadequate to good overall.
[Ratings for all five domains in each service can be found in the notes to editors]
Charlotte Rudge, CQC deputy director of operations for the midlands, said:
“When we inspected services at The Shrewsbury and Telford Hospital NHS Trust, we were pleased to find the trust had made significant improvements since our previous inspection, and people were receiving a higher standard of care.
“Staff told us they now felt proud to work for the trust, there had been a positive shift in culture, and they felt safer to speak up when they saw something that wasn’t right. This enabled staff to feedback any concerns so improvements could be made, in order to improve people’s quality of care.
“During the 18 months before the inspection, there had been two independent reviews of maternity services, which highlighted significant failings. At this inspection, we found improvements had been made and the trust was working hard to build people’s confidence and trust, so women and people using the service felt safe.
“At the last inspection there were concerns in children and young people’s services relating to those with mental health concerns. The service has now implemented lots of changes, including employing a mental health nurse, and having better eating disorder care plans in place.
“However, we did still have some areas of concern, including how the trust were managing the health of people who were waiting to be seen in urgent and emergency care services. Overcrowding and lack of flow through the departments contributed to delays in staff being able to quickly identify and take action when people’s health was at risk of deteriorating.
“Staff had clearly worked hard since our previous inspection to improve the quality of care in most areas.
“We will continue to monitor the trust, including through future inspections, to ensure it builds on the improvements it has already made, and further changes are made and embedded.”
Inspectors found:
- The trust managed safety incidents well and learned lessons from them
- Leaders ran services well using reliable information systems and supported staff to develop their skills
- The trust engaged well with people and the community to plan and manage services and all staff were committed to improving services continually
- It was easy for people to give feedback
- Staff assessed risks to children and young people, acted on them and kept good care records
- Staff worked well together for the benefit of children and young people, advised them and their families on how to lead healthier lives, supported them to make decisions about their care, and had access to good information
- Key services were available seven days a week.
However:
- Staff in some areas did not always treat people with compassion and kindness, respect their privacy and dignity, take account of their individual needs, or consistently support them to make decisions about their care
- Services did not always control infection risk well
- Not all staff understood how to protect people from abuse
- The design, maintenance and use of facilities, premises and equipment did not always keep people safe
- Waiting times from referral to treatment were not in line with national standards.