Arrowe Park Hospital has been slated in a report which revealed vulnerable patients were being cared for in corridors and infection risks were not being properly managed.
The report, based on an inspection from October 8 to November 14 last year, also said the hospital was unclean in certain areas and lacked enough staff to cope with the number of patients it must care for.
The Care Quality Commission (CQC) report, which was published this week, gave the Trust that runs the hospital a rating of ‘requires improvement’, the second worst of the four possible ratings a hospital can be given.
That is the same rating that Arrowe Park Hospital’s emergency department got in its previous inspection last year.
But in this report the hospital did receive a rating of 'good' for its caring approach and improved its leadership rating from 'inadequate' to 'requires improvement'.
Perhaps the hospital’s lack of cleanliness and its vulnerability to infection is the most worrying part of the report, given the current global battle against coronavirus - though the inspection was conducted some months before the first recorded cases in the UK, and before the hospital was used to quarantine travellers returning from Wuhan in China.
The report read: “Services did not always control infection risk well, with staff not always using control measures to protect patients, themselves and others from infection.
“There were areas that were not clean and clinical waste was not always disposed of appropriately.”
There was an infection outbreak at the hospital last year but despite this the relevant practitioners were not always consulted when decisions were made to open wards with a known infection outbreak or infection control risk.
The movement of patients around the hospital was also a major concern in the report, which read: “The service did not discharge patients in a timely manner and did not minimise the number of patient moves between wards at night.
“There were times when patients were cared for in corridors in urgent and emergency services.”
This posed a risk to patient safety.
Inspectors said the hospital must improve the privacy and dignity of patients cared for in the emergency department.
There were also areas where patients did not have access to call bells, vital for getting them assistance in an emergency.
Inspectors said there were sometimes too few staff to cope with the number of patients and in some areas turnover was high, with an increasing number of vacancies.
This capacity issue was not helped by the fact that there were a “high number” of patients still at the hospital despite being fit to be discharged.
The hospital has also failed to meet waiting time targets in recent months.
95% of A&E patients should be seen within four hours, but in December just 72.1% of A&E patients were seen within this time.
Another problem at the hospital was equipment.
In some areas, the hospital lacked the tools staff needed to do their jobs, while in others equipment was poorly maintained or not fit for purpose.
Arrowe Park Hospital’s approach to children’s mental health was also criticised.
This passage of the report is particularly damning: “There was no mental health awareness training in children’s and young people’s services despite staff regularly caring for children and adolescents with symptoms of mental health illness.
“They did not receive training to support those who lacked capacity to make their own decisions in these services.”
In terms of adult mental health, the report said services did not ensure staff had the “knowledge, skills or ability” to care for patients with mental health needs.
But the hospital's caring approach got a rating of ‘good’ in the report, which read: “Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.”
Arrowe Park Hospital’s leadership also improved its rating, from ‘inadequate’ to ‘requires improvement’.
The report read: “Leaders had the skills and abilities to run the service.
“They understood and managed the priorities and issues the service faced. Leaders in services were visible and approachable in the service for patients and staff.”
Governance structures had also improved to make leader’s roles clearer and more accountable.
The report also covered Clatterbridge Hospital, which got the same ‘requires improvement’ rating.
The hospital was criticised for not having the right facilities for rehabilitation services, but it was praised for its ability to control infections.
A statement put out by Wirral University Teaching Hospital this morning, read: “The overall rating of 'Requires Improvement' clearly shows that a great deal of progress has been made and the Trust remains on course to improve ratings further going forward.
“The Trust acknowledges the important work that remains to be done to improve access to services, ease congestion across the wider health system, and further improve the implementation of patient-level risk assessment and management."
Janelle Holmes, chief executive of Wirral University Teaching Hospital, said: “I am really proud of the improvements that have been implemented in the last 18 months to provide better services for people.
“And I pay tribute to our excellent staff who have and continue to work tirelessly in difficult operating circumstances to provide safe and compassionate care.
“I am grateful to the CQC for acknowledging that staff are always respectful and kind.
“It is a testament to the commitment and dedication of frontline teams that CQC rated the Trust as 'Good' overall for caring. Other core services rated 'Good' include our Maternity, End of Life and Diagnostic Imaging Services.
“It is our view that the Trust has been making steady progress to improve and it's pleasing that the CQC has recognised areas of outstanding practice such as prescribing arrangements, supporting staff who are terminally ill, and promoting equality.
“These are aspects of care whereby other providers seeking to improve their services can derive benefit and learning.”