Hospital trust Criticised

An inspection of a hospital trust has found that staff did not recognise signs of abuse in patients and failed to protect the safety and welfare of those who use its services.

Care Quality Commission (CQC) inspectors found that East Sussex Hospitals NHS Trust failed to meet several essential standards of care for patients after reviewing all five of its hospitals in February.

Inspectors identified a lack of staff to support proper patient care in some areas, that care plans and risk assessments were not completed or were inaccurate, that patient dignity was compromised by facilities and staff attitudes, and that patients' rights were not adequately respected.

As a result, CQC raised immediate concerns with the trust's chief executive, demanding that the trust address problems found in A&E, the maternity unit and the wards in Eastbourne District General Hospital and Conquest Hospital in Hastings.

At Eastbourne District General Hospital major concerns were raised over five essential standards. These were said to involve the care and welfare of patients, as inspectors found comprehensive assessments of need were not always carried out and appropriately recorded for those patients tracked.

Staff also could not demonstrate through their nursing records that individual welfare and safety needs were being met.

According to CQC, Eastbourne staff did not understand adult safeguarding processes and did not recognise signs of abuse and how to raise them with the right person in a timely fashion. The culture of care and the provision of treatment in A&E and the wards also lacked a personalised approach.

Inspectors found long and short-term staff shortages across the trust and at all levels, including consultants, middle-grade doctors, qualified and unqualified nursing and midwifery staff, and found a heavy reliance on locums and bank staff.

Arrangements to support staff with annual appraisals and supervision were inadequate, and staff reported low morale.

Similar problems were also found at Conquest Hospital in Hastings, as were issues about patients' privacy and dignity, and inadequacies in the amount of information provided to patients to inform their choices.

Inspectors heard and observed that care and treatment decisions were routinely imposed upon patients rather than informed consent being sought.

Roxy Boyce, regional director of CQC in the South East, said: ``When we visited East Sussex Hospitals NHS Trust in February, we were so concerned about the quality of care provided to patients in many parts of Eastbourne District General Hospital and Conquest Hospital that we raised immediate concerns with the trust.

``The essential standards of quality and safety laid down in law are the standards of care people should be able to expect in any hospital. These include respecting the dignity of patients, helping them to make informed choices about their care and treatment, ensuring their care and welfare and protecting them from unsafe practice and abuse. The care at East Sussex Hospitals NHS Trust fell far short of these standards.

``When we returned to the trust in April to review progress, it was clear that the trust has made considerable efforts to address the outstanding concerns. However, more needs to be done and the progress already made needs to be accelerated and sustained.

``We will continue to monitor their progress extremely closely and will make further unannounced visits.''

Darren Grayson, chief executive of the trust, said he read the CQC's report ``with considerable dismay and concern'' but insisted that since the inspection the trust had taken robust action to address the problems.

He said: ``I would like to apologise to our patients and the public that the identified areas of care have fallen below the expected standard. Most of our patients tell us that they get good care in our hospitals but I cannot condone anything other than the highest standards of care and compassion for our patients.

``It was clear to me that, whilst there were a number of very positive things said by our patients about us, we have further work to do to ensure the care we provide meets the highest standards in every case.

``It is also clear that we have not done ourselves justice as we were not able to demonstrate that we always provide the excellent care that our staff aspire to and that I personally would want for myself and members of my family.

``Since February's inspection, we have invested significantly in both time and resource, to make immediate improvements and to plan and implement medium to long-term changes to achieve sustainable improvements across all areas of concern.

``Our priority is to make sure that we are able to sustain this progress and I am confident that we will be able to do this not least because many improvement actions were already in train at the time of the inspection.

``We welcome this independent scrutiny and recognise that the CQC identified a number of issues where improvements needed to be made when it carried out its inspection in February.''

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