A damning new report said a hospital which serves south Cumbria offered inadequate care and did not have enough medical staff to ‘keep people safe’.
Health watchdog the Care Quality Commission inspected medical care services at Royal Lancaster Infirmary, which is run by University Hospitals of Morecambe Bay NHS Foundation Trust, in August.
It said the unannounced inspection was carried out after it received concerns about risks to patients.
The commission said the hospital’s overall rating was inadequate.
It is also inadequate for being responsive to people’s needs and for how well-led the service is. It is rated requires improvement for being safe, effective and caring.
At the previous inspection in December 2018 the service was rated as good.
This inspection did not change the overall rating for Royal Lancaster Infirmary which remains as requires improvement.
Karen Knapton, CQC’s head of hospital inspection, said: “When we looked at medical care services at Royal Lancaster Infirmary, we saw poor leadership that was impacting on patient care and the experience of staff working there.
“We found there wasn’t always enough nursing and medical staff to keep people safe.
“We saw that staff didn’t always treat patients with compassion or respect their privacy and dignity.
“We observed varying quality of interactions with patients. In some areas, patients were not always supported to maintain their independence with aspects of daily living, such as getting dressed.
“There was a poor culture on some wards. Staff told us that although ward managers and matrons were visible and supportive, senior managers weren’t.
“Staff didn’t feel the managers were always approachable, or that enough actions were being taken to mitigate risks to patients.
“During this inspection, inspectors saw an environment that wasn’t suitable for people’s needs. There was damaged flooring, crumbling walls and broken furnishings.
“There was a lack of dedicated facilities to support older people’s recovery and rehabilitation from illness or injury.
“Since our inspection, action has been taken to move patients into more suitable environments, with plans in place for further service improvements. We were also pleased to see that progress was being made in improving stroke services following our previous inspection.
“We have told the trust leadership team it must have improved and more robust oversight to keep people safe.
“We will continue to monitor the trust closely and return to check on their progress.”
CQC inspectors found:
- Leaders did not run the service well. Staff did not always feel respected, supported and valued. Staff were not always clear about their roles and accountabilities. The service did not engage well with patients and the community to plan and manage services.
- The service did not have enough staff to care for patients and keep them safe. Staff had training in key skills but did not know how to protect patients from abuse and did not manage safety well. Since the inspection, the trust started putting measures in place and was working with external health and social care organisations to minimise any future risks to patients.
- The service did not control infection risk well. The service did not complete records accurately and staff did not always assess the risks to patients.
- The service did not follow national guidelines and did not always have key services available seven days a week.
- Staff did not always treat patients with compassion and kindness, or respect their privacy and dignity
- The service did not plan care to meet the needs of local people, it did not always take account of patients’ individual needs.
However:
- The staff managed medicines well.
- The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
- Staff gave patients enough to eat and drink. Managers monitored the effectiveness of the service. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
- Staff took account of the emotional needs of patients and helped them understand their conditions. They provided emotional support to patients, families and carers.
- Following our previous inspection, the trust was making improvements to the stroke pathway for patients.
- The service made it easy for people to give feedback.
- Staff used reliable information systems. Staff understood the service’s vision and values, and how to apply them in their work.
Tim Farron, Westmorland and Lonsdale MP, said: “The doctors and nurses working at the RLI have been making a Herculean effort to care for patients in almost impossible circumstances.
“So it really saddens me that they will read this report today and feel like yet again they are taking a kicking.
“The blunt truth is that they, and the patients they care for, are being failed by a Government that has cut bed numbers ruthlessly in recent years and failed to invest in services, and a Trust leadership that have their head in the sand.
“Time and time again we hear more bad news coming out of the trust and that improvements are needed – but nothing ever seems to change.
“Meanwhile the Government have helped to create a staffing crisis in social care which has led to a rise in vulnerable and elderly people having to be cared in for in hospitals, adding gigantic pressure onto our local NHS.
“I really do fear that unless we see the Government and the trust leadership start taking this seriously then things will only get worse, and it will be frontline staff that will continue to face undue criticism, and local patients that will be forced to pay the price.”
