Health Safety at BRI requires improvement, watchdog says after spot check
SAFETY at the Bristol Royal Infirmary has been rated as requiring improvement at its latest inspection. The overall rating of the hospital has also changed from outstanding to good.
Robert Woolley, Chief Executive of University Hospitals Bristol and Weston NHS Foundation Trust, has said a full action plan will be developed and it is committed to making the necessary improvements.
In June, the Care Quality Commission (CQC) carried out an unannounced inspection of the trust’s medical care services at both Bristol Royal Infirmary (UHBW’s main site) and Weston General Hospital. The CQC rated the overall trust as good, with the rating for being caring remaining outstanding, but found the safety of services require improvement.
Looking at the BRI in particular, the report found caring and well-led remained outstanding, effective and responsive remained as good but safety required improvement.
On the safety point, the report said the trust provided mandatory training in key skills to staff, but not all staff had completed it. It states: “Medical staff had not all received and kept up to date with their mandatory training. The overall trust target for compliance with training in key skills was 90 per cent. This had not been achieved for medical staff across both the specialised services and medicine divisions.
“Within the medicine division there was a 66 per cent overall completion rate and within specialised services there was a 70% overall completion rate. There were significant gaps in training around fire safety, life support and safeguarding training.”
It addd: “The service had enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
“Managers regularly reviewed and adjusted staffing levels and skill mix, and gave bank and agency staff an induction. However, staff felt pressured and impacted by ward changes.”
And it added: “Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, and easily available to all staff providing care. Some patient identifiable and confidential information was not always stored securely.”
The Weston site was rated as inadequate overall as, while caring was rated as good, effective and responsive were rated as requiring improvement and safe and well-led were rated as inadequate. At Weston General Hospital the CQC was concerned the clinical leadership was not effective and there were not enough staff to meet the needs of patients.
Following the inspection, the CQC imposed urgent conditions requiring rapid improvements to ensure the safe care and treatment of patients at Weston General Hospital, including ensuring there are enough nursing and medical staff in all areas.
Dr Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals, said: “This is the first inspection to rate how well-led the newly formed University Hospitals Bristol and Weston NHS Foundation Trust is, following the merger of two trusts in 2020. Our inspectors found a strong patientcentred culture with staff committed to keeping patients safe. Patients and relatives spoke highly of staff.”
However, he added: “As with all mergers, there are generally areas which a trust will need to address and we were disappointed to find a lack of awareness amongst the leadership team regarding medical care at Western General Hospital, which is now rated as inadequate. There was also a lack of partnership working between the Bristol main site and Weston General Hospital. It was also concerning that the team was not on top of some major concerns, including the supervision of junior doctors at Weston General Hospital which had triggered quality intervention visits from Health Education England and the General Medical Council. We are aware that since then they have been working to put immediate and significant improvements in place and we will return to check on their progress”
UHBW’s chief executive Mr Woolley said: “We welcome this CQC report and the overall rating of Good for the organisation and were pleased inspectors found many positives, including how staff treat patients with compassion and kindness and take account of their individual needs and help them understand their conditions. It’s this commitment and focus on the needs of our patients which has enabled us to retain our rating of Outstanding for caring.”
He added: “We know there are areas we need to address, and we know what we need to do. We have already tackled some of the issues.”