A report by the Care Quality Commission has downgraded medical services at the Royal United Hospital from ‘good’ to ‘requires improvement’ after a number of safety issues were identified.
Photo courtesy of the RUH
The Care Quality Commission (CQC) carried out an unannounced inspection at the RUH in July after receiving “information of concern” regarding the safety and quality of the medical care being provided.
Inspectors looked at whether the medical services offered at the hospital were “safe and well led”, but did not inspect if they were caring, effective or responsive.
The last comprehensive inspection of the RUH Trust in June 2018 found it to be ‘good’ overall.
Medical care, which had previously been rated as ‘good’, now ‘requires improvement’.
The RUH as a locality now ‘requires improvement’, while the Royal United Hospitals Bath NHS Foundation Trust as a provider remains ‘good’.
The Royal United Hospital site at Combe Park in Bath has 12 medical inpatient wards, hosting 381 beds.
The CQC found issues regarding the design, maintenance and use of facilities at the site. Some wards lacked storage space and/or required maintenance work.
In the 22-bed Cheselden Ward, inspectors found damaged flooring and a shower room being used as a storage room for equipment, meaning it could not be used by patients.
Inspectors also noted that patient fluid charts were inconsistently completed, so staff didn’t always have the most complete information to support patients. This could lead to patients being at risk of dehydration.
Despite an “influx” of newly qualified nurses to the hospital, there was a shortage of health care assistants. Inspectors said that staffing levels were adjusted to meet demand, and all staff received inductions as required.
Issues were also raised including the recording of medicine in line with hospital policy, the secure storage of patient files, and further training being required to ensure processes were being met.
The inspection report states that the hospital trust had enough staff to keep patients safe from avoidable harm and provide the right care and treatment.
Inspectors also noted that staff understood how to protect patients from abuse, and safety incidents were well managed, with incidents and near misses being reported.
The CQC praised the hospital’s programme offered for international nurses, in terms of education and pastoral care, saying it was ‘outstanding practice’.
In a statement, a spokesperson for the RUH said: “We welcome the report and we are fully committed to making the improvements identified in their report supported by a robust action plan.
“The Trust has already started work on the improvements required.
“We were pleased that the report also identified many positives, inspectors praised the ‘outstanding programme’ for international nurses, our ability to manage patient safety incidents well and the way managers and ward leaders were supported to make the wards a welcoming place to work.
“Inspectors noted that our Medical Care Service ‘had enough medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment’.
“The CQC also acknowledged that we have a strong vision and strategy developed in partnership with the people we care for, the people we work with and the people in our community.
“The RUH is committed to being an organisation where everyone matters and we would like to reassure patients that our staff remain fully committed to providing the very best standards of care at all times.”
