The Care Quality Commission (CQC) has again rated medical care services at Royal Oldham Hospital, run by the Northern Care Alliance NHS Foundation Trust as requires improvement following an inspection in August last year.
The inspection was prompted by information of concern CQC received from the public about the quality of care at the service.
Following this inspection, in October last year, CQC issued a warning notice to focus the trust’s attention on making specific improvements to the safety, oversight, and the dignity of people being cared for in temporary escalation spaces after finding a breach in regulations.
CQC also found other breaches which were not part of the warning notice in regulations linked to staffing, health and safety, and how the service was being managed.
Despite these issues, CQC also found some areas of improvement in medical care services and as a result the rating for how responsive the service is, has moved from requires improvement to good. Safety, effectiveness, and leadership have been rated as requires improvement again, and how caring the service is has again been rated as good.
Alison Chilton, CQC’s Deputy Director of Operations in Greater Manchester said:
“When we inspected medical care services at Royal Oldham Hospital, we found staff who showed kindness and compassion in their day-to-day work. We were also pleased to see the improvements leaders had made to how responsive the service was to people’s individual needs.
“However, the trust must make improvements in the model they used to care for people in temporary escalation spaces as we had concerns about people’s safety and dignity. Our concerns included the trust not having clear processes for decision making, and a lack of clinical and environmental risk assessments. Staff had also raised similar concerns to leaders but hadn’t felt listened to.
“This is why we issued the trust with a warning notice, to focus their attention on making those changes rapidly. They also had some work to do around staffing, health and safety, and how the service was being managed
“Despite these issues, there had been improvements in how responsive the service was. They understood the diverse health and care needs of local communities and provided information in formats tailored to people’s individual needs. People using the service also told us they were involved in making their care plans and felt treated as individuals, with their protected characteristics considered.
“Staff showed kindness and compassion, and we saw a nurse on the geriatric medical unit skilfully de-escalate a challenging situation involving someone with complex needs.
“We’ve told leaders where we expect to see improvements and will monitor them to make sure people are safe whilst this happens.”
Inspectors found:
- Staff responded quickly to people whose health was at risk of deterioration and there was a positive safety-focused culture across the wards.
- Teams worked well together in a culture of evidence-based practice and shared information effectively.
- People told CQC they felt safe and were confident they would be treated with compassion if raising concerns.
- Staff across the service had good access to specialist support services including speech and language therapy, physiotherapy, dieticians and mental health support.
- Care was planned and organised with people and stakeholders to maintain safety and continuity of care.
- There were appropriate forms, personalised care plans and medicines in place for people at the end of their life.
However:
- Leaders had the skills and experience to carry out their roles but did not always have resources and space to manage the priorities and issues the service faced.
- People’s care was sometimes compromised by staffing shortages, with one ward reporting 20 healthcare assistant vacancies. People using the service also told CQC they didn’t feel there was always enough staff on the wards.
The report will be published on CQC’s website in the coming days.