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Mid Cheshire Hospitals NHS Foundation Trust rated Good by CQC

18/09/2018

England’s Chief Inspector of Hospitals has rated Mid Cheshire Hospitals NHS Foundation Trust as Good overall, following a May 2018 inspection by the Care Quality Commission. The trust was last inspected in October 2014, when it was also rated Good.

The core service inspections were unannounced however the well-led inspection was announced.

England’s Chief Inspector of Hospitals, Professor Ted Baker, said:

“Since they were last inspected in 2014, Mid Cheshire Hospitals NHS Foundation Trust are still rated as Good.  The overall rating for safety went down to Requires Improvement. This is because inspectors observed failures to follow infection prevention and control procedures on a number of occasions; a lack of suitably qualified people in some departments. Inspectors noted that in the emergency department there was a shortage of children’s nurses.

“However, we did see excellent collaborative working, particularly within community services. Leadership at Board level was very good with members understanding the need to improve and sustain the improvement.

“The trust was committed to improving services by learning from when things go well and when they go wrong, promoting training, research and innovation. The executive group were cohesive and remarkably consistent in its response to questions. I was encouraged to see that directors gave account of their personal walkabouts to monitor the quality of care.”

You can read the latest reports in full by clicking on this link: http://www.cqc.org.uk/provider/ RBT once they have been published on the CQC website.

Safety across the trust went down from Good to Requires Improvement; this was attributable to a number of factors. Infection control measures failed to fully protect patients as did a lack of suitably qualified people in some departments. Inspectors noted that in the emergency department there was a shortage of a children’s nurse.

Across the trust, effectiveness, caring and well-led remained the same at Good. Responsiveness improved from Requires Improvement to Good. There was a strong leadership culture with a stable Board that understood the challenges to quality and sustainability. 

Inspectors noted some outstanding practice including:

  • A newly developed frailty service in the clinical decisions unit was starting to reduce the number of patients admitted to the hospital and reduce the number of re-attendances. There was good evidence of multi-disciplinary team work - making sure patients were transferred or discharged to the appropriate location at the right time.
  • The trust had an Advanced Nurse Practitioner Rapid Response team to provide support to acutely ill patients who would usually be admitted to hospital. They received referrals from across communities and responded to patients within two hours to avoid hospital admission. Patients were assessed at home by an advanced practitioner and supported to remain at home with an appropriate care package. 

At the Victoria Infirmary the overall rating for emergency services was Requires Improvement although its rating for all services was Good. Inspectors said that although emergency services had enough staff they were not assured that staff had all the competencies in particular, to care for children.

The overall rating for Leighton Hospital remained the same at Good. Records were clear and up to date and staff understood how to protect patients from abuse and the service worked well with other agencies to do so.

Safety in the emergency department is now Requires Improvement. The emergency department was visibly dirty, dusty and cluttered and staff did not follow infection control processes consistently.

Across the trust the overall rating for medical care, including older people went down to Requires Improvement. Inspectors found that records were not always stored securely and Individual risks to patients were not always clearly documented.

Community health services for adults, across the trust were rated as Good. CQC had not previously rated this area and found staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care - there were good examples across all services where integrated care was provided.

Community health services for children and young people had not previously been inspected. At this inspection it was rated as Requires Improvement.  Not all safety incidents were appropriately recognised, recorded, monitored and investigated. The safety of patients and some medication prescription charts reviewed were out of date. However, inspectors observed numerous examples of multi-disciplinary working with clinicians co-operating and collaborating around the needs of children, young people and their families.

You can also view Healthwatch Cheshire East's Enter and View reports regarding Mid-Cheshire Hospitals NHS Foundation Trust.

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