The Care Quality Commission (CQC) has recently identified a series of breaches of safety and quality standards at Scarborough and North East Yorkshire Healthcare NHS Trust, ordering the Trust to take immediate action. CQC said there was no evidence of harm to patients as a result of the breaches.
However, the high number of breaches presented a serious concern. CQC published two reports, which detail a range of issues at the Trust. These include concerns about staffing levels, buildings and maintenance, patient records, safeguarding arrangements and systems for assessing and monitoring service quality. At Scarborough Hospital CQC inspectors found the Trust was fully compliant with only one of the 16 essential standards of quality and safety. Of the 16 standards, it had a major concern in respect of five. At Bridlington Hospital inspectors found the Trust was fully compliant with six of the 16 standards and had a major concern in respect of one of the standards. Some of the most significant concerns, found at Scarborough Hospital, included:
• Care and welfare of people who use services: Records which should have been kept by nurses to assess, plan and deliver care were incomplete in places, particularly on the medical wards.
• Staffing: A shortage of junior doctors was due to be addressed during the summer. Inspectors noted that numbers of medical staff on duty did not match numbers required by staff rotas in some areas, such as A&E. After 1 am, only junior doctors were routinely available in A&E, although senior doctors were on call. On a number of occasions, numbers of nursing staff were lower than the levels deemed by the Trust itself to be safe.
• Safety and suitability of premises: Inspectors noted a backlog of maintenance work, and numerous general safety issues, including disabled access, trip hazards and poor signage. There was no process to report findings of any environmental risk assessments to the facilities directorate.
• Assessing and monitoring the quality of service provision: Records containing risk assessments and clinical audit findings were mostly poor. Inspectors found significant concerns about the effectiveness of monitoring arrangements and the Trust’s ability to regularly assess and monitor the quality of services.
