IMPROVEMENTS need to be made to health services in Torbay and South Devon - that’s the verdict of inspectors from the Care Quality Commission.
It has declared Torbay Hospital’s accident and emergency department is ‘too small’ and inspectors saw several incidents which could be a risk to patient safety.
Inspections were carried out at urgent and emergency care, outpatients, medical care, and diagnostic and imaging services following concerns raised about staffing, referral to treatment times, ongoing delays in ambulance handovers and waiting times.
The CQC, which carried out the checks on three consecutive months in the summer, concluded that the Torbay and South Devon NHS Trust’s rating is now that it requires improvement but retains its ‘outstanding’ for caring.
Cath Campbell, CQC deputy director of operations in the south, said: ‘We saw several issues with the environment at the urgent and emergency and outpatients departments at Torbay Hospitals which could be a potential risk to people’s safety. The emergency department was too small for its growing needs, and some areas were overcrowded with equipment and people too close together.
‘The outpatient department was almost 100 years old and like the emergency department, the size and needs of the population it serves had grown and the hospital had not grown along with it, so it was no longer fit for purpose.
‘We’ve reported our findings to the provider, and they know what they must address and the areas in which they’ve improved.
‘We’re working closely with the trust to ensure people are receiving safe care and we will return to inspect the trust to make sure more improvements have been made.’
She said leaders were found to have the ‘skills, experience, and capacity to manage’ the trust and were aware of the challenges the trust faced as well as the whole local healthcare system and were working to tackle these.
The CQC said the trust is currently in the ‘national oversight framework segment 4’ due to its financial performance issues and delivery against performance targets, and is receiving support from NHS England.
It findings said staff satisfaction was ‘mixed’, but the board had ensured a plan of improving the culture and staff satisfaction was seen as a priority.
Among the issues were that while staff views and concerns were ‘encouraged’ they were not always acted on.
In urgent and emergency care, the team found the department did not meet national recommendations including waiting and treatment areas for children and families in crisis.
Some computer screens were left open and unsupervised with people’s records visible. But they said staff treated people with compassion and kindness, respected their privacy and dignity.
In diagnostic and screening services, inspectors found checks to make sure the right person received the correct scan were not always effective and in medical care inspectors found outcomes for people were not always positive and consistent and did not always meet national standards. People were not always admitted to a stroke unit within four hours and did not always spend 90 per cent of their time on a stroke ward, in line with national guidance.
Inspectors also found staff understood how to protect people from abuse, and managed safety well, kept good care records and managed safety incidents well and learned lessons from them.
In outpatients inspectors found staff said they sometimes needed to work extra hours to ensure there was enough staff to keep people safe.
Harm had come to people waiting to be seen in ophthalmology because risks to people on waiting lists were not always identified. People could not always access the service when they needed it and had long waits for treatment.
Following the report, Liz Davenport, Chief Executive, Torbay and South Devon NHS Foundation Trust, said: ‘We welcome the publication of the CQC report which reflects our challenges and our strengths.
‘We feel it is a fair reflection of the issues our teams and our organisation face. The majority of the areas for improvement were already known to us and work is well underway to address these.
‘We are proud that our people’s commitment to compassionate care is recognised and we have retained our outstanding for care rating. Our people work tirelessly to provide the best possible care.
‘We are pleased that the inspection recognised our focus on continuous learning and improvement and we will use the findings of the inspections to help us make things better for our people and our communities.
‘We recognise we have more work to do to show our people how we are acting in response to concerns they have shared with us.
‘We know we have much more to do to tackle inequalities for our people and our communities and our inclusion plan is shaping and directing our work to create a culture where our people are safe and healthy.
‘We have some of the oldest NHS estate in the country which poses particular challenges. This has been recognised nationally and is why we are included in the new hospital programme which will deliver modern, fit for purpose environments in which to deliver high quality, safe healthcare. In the meantime, our dedicated staff continue to try to make the best use of our buildings.
‘Since the inspection we have relocated our children’s emergency department and this now has a separate waiting area which is compliant with CQC standards as well as a triage space and treatment area.
‘We are working together with partners to address our financial and operational performance and we are making progress. A number of the challenges we face require a system solution and as the inspection report recognises our commitment to working in partnership to improve services.
‘Our waiting times are reducing and our performing is improving across planned care and cancer services but we know we have much more to do to make things better for everyone in Torbay and South Devon.’