Inspection and Regulation

18.09.18

Devon NHS Trust remains in ‘requires improvement’ after latest CQC inspection

A Devon-based NHS trust will remain in the ‘requires improvement’ rating after the health inspectorate deemed that, despite improvements, some services require further work in its latest report.

The CQC’s inspection at North Devon District Hospital in July this year was an unannounced follow-up inspection focused solely on improvements that were required by a warning notice issued after the previous inspection in October 2017.

Inspectors found that services provided by the Northern Devon Healthcare NHS Trust including safe, effective, responsive and well-led were rated as ‘requires improvement,’ whilst caring was rated as ‘good’.

In the urgent and emergency area inspectors found the department to be “visibly dirty” in some areas, and a number of serious incidents were found in the maternity department; including medical staff not being up-to-date with mandatory training and not always responding promptly when requested by the midwifery team.

In terms of the trust being well-led, the maternity department was again criticised by the CQC report, claiming: “A long-standing poor working culture in maternity meant the delivery of safe and good quality care was at risk. Governance arrangements were not well-embedded and not aligned with the trust structure.

“The risk management process was unclear and there was not a designated obstetrician and midwife who were jointly responsible for championing maternity safety in the trust. However, the midwifery team felt supported by their leaders,” the report added.

Inspectors also found that the urgent and emergency services performance against the four-hour target was “consistently above the national average,” with the waiting area being small and crowded and the reception desk remaining unsuitable for wheelchair users.

Although several issues were raised by the CQC report, the rating of caring stayed the same, with urgent and emergency services staff understanding personal, cultural, and religious needs of people. In end of life care staff were compassionate and kind.

Chief inspector of hospitals Ted Baker said: “After this inspection, whilst it is fair to say that some progress had been made, it is clear that further work needs to be completed to ensure that the required systems and processes are fully embedded to continue these improvements.

“At present, the requirements of the warning notice have not been fully met and we have issued the trust with two requirement notices which make it clear to the trust the actions it must take to improve services.”

Suzanne Tracey, chief executive of Northern Devon Healthcare NHS Trust, said: “It is really positive that the CQC have recognised the improvements we’ve made. This shows that we are heading in the right direction.”

“The report also highlights that, at the time of the visit in July, the CQC felt more work needed to be done to improve the quality of the trust’s services. We recognise that there is work to do to address some of the more complex issues, but I am confident that we now have the right plans and priorities in place to get there.”

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