Unsafe staffing levels put kids at risk at Kent hospitals - CQC report
East Kent Hospitals University NHS Foundation Trust says it has taken "immediate action" following the report.
Wednesday 13 February 2019 15:55, UK
Children were being put at risk due to "unsafe" staffing levels at two hospitals run by one of England's largest NHS trusts.
Children's departments at the William Harvey Hospital (WHH) in Ashford and the Queen Elizabeth The Queen Mother Hospital (QEQM) in Margate were rated inadequate following unannounced inspections in October.
Most notably, the Care Quality Commission (CQC) report found both hospitals failed to provide round-the-clock cover in children's emergency departments, forcing patients to wait in the main A&E where they were at risk of being exposed to "volatile behaviour, inappropriate television programmes and unpleasant sights".
Staff at both hospitals had not been trained nor had the resources to care for children with mental health conditions or learning disabilities, inspectors found.
The report rated East Kent Hospitals University NHS Foundation Trust, which runs both hospitals, as requiring improvement.
Issues at QEQM included:
:: Some patients were having to wait more than an hour to be handed over to the hospital by the ambulance.
:: Nurses revealed how they routinely missed breaks, had no drinks and worked "well beyond their contracted hours".
:: The children's emergency department was not staffed overnight from 2am to 8am so casualties were sent to the main A&E.
:: Inspectors also raised wide ranging concerns over cleanliness and hygiene, safety of patients, record keeping, storing medicines and leadership.
:: Equipment was missing from resuscitation trolleys and medicines were not being kept at the right temperature.
:: Nurses were seen carrying out duties without wearing gloves and a locum doctor did not wash their hands or wear protective gear when examining a child with chicken pox.
:: Steps were not taken to separate children with potentially infectious illnesses from other patients - or clean down rooms after they had been examined.
:: Guidelines for screening and treating children for sepsis were not being followed or understood.
Issues at WHH included:
:: Staff said they worked beyond their contracted hours and missed lunch breaks due to "unsafe staffing levels".
:: Inspectors found no nursing staff on duty in the children's emergency department between 4pm and 2am, leaving patients to wait in the main A&E.
:: Staff were seen using a stethoscope which was not cleaned between patients.
The CQC issued a string of recommendations on how the trust must improve at both hospitals.
Doctor Nigel Acheson, the CQC's deputy chief inspector of hospitals, said: "It is clear that the children's services at East Kent Hospitals University NHS Foundation Trust have been working under some pressure, apparently with no end in sight.
"We could not allow this to continue - and we used our enforcement powers to ensure that appropriate action is taken to protect young patients.
"I am pleased to report that since our inspection, the trust has assured us that the service has made significant improvement and we should be in a position to remove the conditions in the near future."
The trust said it had taken "immediate action" and made "significant changes", including increasing staffing levels and re-training staff as part of an "intensive 12-month improvement programme".