‘Poor practice’: KGH emergency department told it must improve after latest inspection

KGH's emergency department has been criticised for areas of 'poor practice' in a report by the Care Quality Commission (CQC)
KGH's emergency department has been criticised for areas of 'poor practice' in a report by the Care Quality Commission (CQC)

KGH’s emergency department has been criticised for areas of ‘poor practice’ in a report by the Care Quality Commission (CQC).

The health regulators inspected the department in February this year after concerns were raised about the safety of patients being cared for in the corridor area.

In a report published today (Wednesday), the CQC highlighted a number of areas where the department did not reach the expected standard.

Inspectors found patient records lacking sufficient detail, with risk assessments not always completed.

Patient records in the department’s paediatric area were not always stored securely and were accessible to anyone who entered.

Inspectors also found patients’ privacy and dignity was not always respected while being cared for in the corridor of the department.

KGH’s director of nursing and quality Leanne Hackshall said: “We have addressed all of the issues raised by the CQC.

“For example in A&E we have introduced two-hourly care rounds undertaken by the nurse and doctor in charge to address improved patient assessment.

“We have changed the way in which staff are rostered to deliver improved care in the paediatric area of the department and more nurses with a paediatric speciality qualification are being recruited.

“Existing A&E staff are also being trained in paediatric competencies to ensure we have better 24/7 cover.

“A review of documentation within the department is under way to make it easier for practitioners to accurately record all aspects of care and we have improved security to the paediatric area of A&E with swipe card access.

“We continue to work very closely with the CQC to resolve all of these matters before our next full inspection.”

The inspection took place before KGH opened an extension to its A&E department in May, having opened a new discharge lounge in March.

The hospital has been under pressure after a surge of attendants saw the number of people attending A&E increase to 240 patients per day.

The volume of attendants was recognised by the CQC, which praised staff for their caring attitude in difficult circumstances.

Miss Hackshall added: “We have welcomed the CQC’s follow-up visit.

“Inspectors reported that our staff were caring and considerate towards patients and their families.

“They said we managed our staffing and skill mix levels appropriately and ensured patients received good regular reviews – including daily consultant reviews.

“They recognised that we are a very busy organisation and that, during the winter, we have had to open escalation capacity to meet an increasing year-on-year demand for A&E and hospital beds.

“They have also recognised that the trust has been actively tackling these issues with its health and social care partners and by improving the way it manages flow through the hospital.

“For example, we invested in the creation of a new A&E majors unit which opened on May 1, which has significantly improved our emergency care facilities.

“We have also taken a number of other measures including developing a new discharge lounge and other best practice improvements to our systems and processes.”

The trust was told by the CQC that it must ensure effective systems are in place to monitor and address risks to the safety and quality of patient care in the department.

It must also ensure that all patients receive appropriate and timely assessments of needs and that effective care and treatment is provided in a timely way.

They must also review nurse staffing within the paediatric emergency department to ensure a paediatric-trained nurse is present to care for children.