Health watchdog inspectors makes string of worrying findings at Princess Royal Hospital in Orpington
PUBLISHED: 10:00 13 June 2019
A health trust which runs a hospital in Orpington has been told by watchdogs that it Requires Improvement after inspectors found a catalogue of worrying warning signs at its emergency department.
The King's College Hospital NHS Foundation Trust has been criticised by the Care Quality Commission (CQC) as inspectors deemed it Requires Improvement overall.
It received the same rating at its last inspection.
It gets the same rating for being safe, effective, responsive and well-led.
The CQC did rate it as Good for being caring after an inspection in January and February, but shows no improvement since the previous overall rating of Requires Improvement.
During its latest inspection, from January 30 to February 21, the CQC inspected locations including Princess Royal University Hospital (PRUH) in Farnborough, including the emergency department, surgery, end of life, and outpatients.
It also spoke to 156 staff members from across a range of roles, and spoke with 57 patients and/or their relatives.
Formal documentation and 59 patient records were also examined.
The CQC's full report paints a worrying picture.
It reads: "At Princess Royal University Hospital and its south sites, we found a deterioration in expected standards in the Emergency Department.
"Our findings indicated some inadequacies in safety standards, the responsiveness of the service and its overall leadership."
This, inspectors found, meant the effectiveness of services at the emergency department had actually gone down since its last inspection.
At PRUH, according to inspectors: "The environment in which people received treatment and care was not always suitably safe and risks had not been fully considered in some areas.
"The privacy of patients in some areas was less than expected."
In one example mentioned in the report,inspectors found the trust was inconsistently checking equipment was suitable for use and a number of consumable items seen within the hospital were out of date.
Inspectors also found that "staff did not always follow best practice when storing, supplying, preparing or administering medicines."
Concerns were also raised that the privacy and dignity of patients was not always maintained in the hospital's Outpatients unit "because of the environment".
The PRUH's urgent and emergency services, which receive around 500 seriously ill patients a month, were rated as Inadequate - the worst rating the CQC can give.
The inspection found that "patients were not always protected from avoidable harm", and that patients who needed resuscitation were being managed poorly "due to flow challenges".
A CQC spokesman said: "There was a lack of effective leadership in the emergency department at PRUH.
"This had got worse since CQC's previous inspection.
"Morale amongst administrative staff across most outpatient services at KCH was low.
"Staff in some clinical areas did not feel valued or respected.
"CQC inspectors found in some of the core services there was a disconnect between what the executive did and how this was perceived by staff.
"The trust had not ensured that mandatory training was completed to the expected target."
It said staffing levels in some key areas did not always meet the needs of the services being delivered.
The trust was told to make improving including ensuring patients and visitors are treated with kindness and compassion in the emergency department and ensuring all rooms where patients are seen and treated have call bells.
England's chief inspector of hospitals, Prof Ted Baker, said: "It is disappointing there has been no overall improvement in the rating at King's College Hospital NHS Foundation Trust. In fact, in some areas the trust has gone backwards.
"For example, there was a lack of effective leadership in the emergency department at Princess Royal University Hospital. This had got worse since CQC's previous inspection."
A Trust spokesman said: "There are areas that require focused attention in terms of patient care, staff morale and running our hospitals more effectively and efficiently.
"We have already taken immediate action to tackle the issues at the Princess Royal University Hospital Emergency Department, improve our performance as well as working with staff to improve morale."