Following Southport and Ormskirk Hospital NHS Trust’s latest Care Quality Commission inspection report, the overall rating of ‘requires improvement’ raises concerns for the year ahead.

In November 2019, the CQC published their rating of the services provided by various departments within the Trust. These include Surgical, Urgent and Emergency Care and Outpatients.

Significantly, issues the Trust were advised about in a 2017 inspection have not improved.

These include:

1. Completion levels of mandatory training for resuscitation (61%).
2. Concerns relating to the storage of hazardous materials.
3. The use of bed rails which was not consistent with the trust’s policy.
4. Patient needs not always assessed, representing safety risks.
5. The management of controlled drugs.

The latest CQC report feels like Groundhog Day for many patients

In addition, repeat issues published in the Trust’s board meeting notes published last October do little to alleviate pressure on the hospital’s overall care.

Both the CQC report and the meeting notes identify patients without access to basic needs and a failure to appropriately complete risk assessment forms.

In total, the CQC found 91 areas that the trust ‘should improve’ and ‘must take action to bring services into line with 31 legal requirements’.

From a legal standpoint, it is important to get beneath the findings.

One of the core areas marked for improvement falls under Surgical Services.

Between July 2018 and June 2019, there were 3,961 surgical admissions and 1,125 trauma and orthopaedic admissions.

Orthopaedic admissions include elective surgical procedures such as hip and knee replacements in addition to emergency admissions.

The surgical services provided were rated as ‘requires improvement’ because:

1. Compliance rates for mandatory training below the trust target, patient records not clear or securely stored and processes in place to prescribe, administer, record and store medicines were not safe.
2. At times patients were delayed leaving recovery following surgical procedures.
3. The service did not use systems and processes to safely prescribe, administer, record and store medicines.
4. Complaints not always investigated in a timely manner.

The elderly and most vulnerable in society are suffering the most

My experience in handling multiple and often complicated clinical negligence cases tells me it is the most vulnerable patients who suffer.

I refer to the Trust not ‘using systems and processes to safely prescribe, administer, record and store medicines.’

Such medicines are essential to comforting the elderly and determine the quality of life they go on to lead.

The report then goes on to conclude, ‘the hospital’s services did not ensure medicines were always safely prescribed, administered and stored.’

Away from medicinal management, a failure to follow risk assessments is also under review.

The report states, ‘staff did not always complete and update risk assessments for each patient and they did not always remove or minimise risks.

“Staff did not consistently complete and update risk assessments for each patient. We saw examples where patients at risk of falls or who had fallen did not have falls risk assessments completed. Following our inspection, the service took immediate action to improve care to patients at risk of falling.”

Consequently, the trust’s Month by Month Hospital Standard Mortality Ratio is described as ‘inherently unstable.’ [Page 34/2010]

My team are already aware of several falls within a three-month period that the CQC have attributed to incomplete risk assessments.

Whilst there are clear and obvious concerns, the CQC also found that several services provided by the Trust were good. It praised the trust for having “developed a strategy and vision” since the last inspection and its outstanding practice in physiotherapy.

Hospital Deputy Chief Executive and Director of Strategy, Therese Patten said the report showed the trust was “on track to meet our ambition of being rated good by 2020”.