Updated 17 November 2021
We carried out an unannounced focused inspections of the following acute services at The Princess Alexandra Hospital:
- Urgent and emergency care to look at those parts of the service that did not meet legal requirements
- Medical Care (including older people’s care) because we had concerns about the quality of services and to look at those part of the service that did not meet legal requirements.
- Maternity because we had concerns about the quality of services.
- We also inspected the well-led key question for the trust overall.
We did not inspect any of the other services at the trust as we did not have any information of concern and all other services were previously rated as good. Our rating of services stayed the same. We rated them as requires improvement because:
- We rated safe as requires improvement and well-led as requires improvement. Effective and responsive remained as requires improvement and caring remains as good. Well-led here is the overall trust-wide rating, not an aggregation of service ratings.
- We rated one of the trust’s services as inadequate and two as requires improvement. In rating the trust, we took into account the current ratings of the five services not inspected this time.
- Staff did not always complete risk assessments for each patient in a timely manner. They did not always remove or minimise risks to patients. Staff did not always keep detailed and contemporaneous records of patients’ care and treatment. There was inconsistent systems in place to ensure learning from incidents was shared and embedded.
- People could not always access the services they needed in a timely manner and performance in some areas was below the regional and national average.
- There were still not effective governance systems and processes in place to ensure the delivery of the strategy and quality patient care.
However:
- Despite the challenges of the pandemic the trust continued to engage with staff, patients and their representatives and system partners in an open and transparent manner.
How we carried out the inspection
We carried out the core service inspections on various days throughout July and August 2021, with the trust wide well-led inspection undertaken in September 2021.The trust well-led inspection was carried out entirely virtually to minimise disruption and in line with our methodology due to the pandemic. We visited areas relevant to each of the core services inspected and spoke with a number of patients, staff and patient representatives.
We spoke with 105 members of staff at all levels of the organisation across all specialities and including healthcare assistants, nurses, midwives, junior doctors, pharmacy staff, consultants and administrative staff.
We also spoke with 21 patients and their relatives and six patient representatives. We observed care and reviewed 26 sets of care records. We also looked at a wide range of documents including policies, standard operating procedures, meeting minutes, action plans, risk assessments, training records and audit results.
You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.