05.03.14
CQC demands ‘urgent improvements’ at Medway A&E
Inspectors responding to anonymous concerns raised with the CQC about the emergency department at Medway Maritime Hospital found overcrowded, dirty, mixed gender bays and staff who felt “under siege” due to a lack of capacity.
The department had cubicles with “visibly dirty radiators and paintwork, stained floors and dirty wash hand basins, and blood spatters on a wall in the Vanguard unit”.
The CQC said: “When inspectors arrived, 20 patients had been in the department for more than four hours. Seven of these had been in the unit for over 11 hours, and one patient had been there for in excess of 19 hours. The previous night, inspectors were told, there had been up to 17 people on trolleys in the corridors waiting to be seen, and 16 ambulances queuing to bring in more patients.
“One patient waited four hours for a blanket. Another had not been offered any food or drink for 18 hours.”
This overcrowding is “severely” affecting care and treatment, although people’s verdicts on the care they did eventually receive was positive.
Medway NHS Foundation Trust has been formally warned that it needs to improve care in the department, as it is failing to meet national standards on care and welfare, and on cleanliness and infection control.
Adrian Hughes, regional director of CQC in the south, said: “We know that the trust is taking steps to improve its services – but during our inspection one member of staff told us that they felt ‘under siege’, while another said that they did not feel supported. There were too many patients for the capacity in the department. It is clear that the work taking place to make improvements has not yet translated to better patient care in the emergency department.”
Inspectors will soon be returning to the trust, which has been branded one of the country’s “most challenged”, and which was also criticised in Sir Bruce Keogh’s report into high death rates.
The trust’s chairman and chief executive – Denise Harker and Mark Devlin –announced their joint resignation at the end of January. Monitor appointed Nigel Beverley as interim chief executive and Christopher Langley as interim chairman.
In response to the CQC report, chief nurse Steve Hams said: “We are sorry that the emergency department failed to live up to the high standards of care we want to provide for our patients and which they have a right to expect. I want to apologise personally for letting our patients down.
“The emergency department was designed to treat 50,000 patients a year, but now it is treating 90,000 and rising. We know it is not suitable for emergency and critical care in the modern world and are working hard to put it right.
“On 31 December 2013 at 7am – the morning after one of the busiest evenings in recent times – there were unprecedented levels of ambulance activity, seriously ill patients presenting with complex conditions, local floods and a norovirus outbreak. We took immediate action. We introduced a daily executive director-led review of the department; implemented a new executive director rota providing an on-site presence seven days a week and during bank holidays, carry out patient safety rounds by the matron and consultant three times a day focussing on nutrition, hydration, pain relief, good documentation, talking to patients and a clean, safe environment.
“We have recruited more clinical and non-clinical staff, and the infection prevention and control team carry out weekly unannounced visits.
“The emergency department is a much cleaner, safer and more efficient environment than when the CQC visited and we will carry on improving. This week we started work on a complete redevelopment of the emergency department, the first phase of which will be ready for next winter.”
(Image copyright Phil Dillon, used here under a Creative Commons licence)
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