BUT COVID CRITICISM
THE CQC PRAISED STAFF BUT SAID THE AGE AND DESIGN OF THE HOSPITAL MADE SOCIAL DISTANCING DIFFICULT
COMMODES stored in bathrooms being used by patients created a Covid infection risk at Burton’s Queen’s Hospital, health inspectors have found.
The Care Quality Commission (CQC) inspectors visited the Belvedere Road hospital – and the Royal Derby – in April after 58 Covid outbreaks across the two facilities.
Now a report documenting the inspection has been published – and it says Queen’s Hospital’s narrow corridors made it difficult to socially distance. Both hospitals are part of the same trust.
The CQC report reads: “One of the main infection prevention and control risks was the age and condition of the estates at Queen’s Hospital Burton in Belvedere Road.
“The service was undertaking ward renovations which were postponed due to Covid-19 outbreaks but had since resumed. The estates did at times make social distancing difficult due to corridors being narrow and side rooms being smaller.
“The service also had a lack of ensuite bathrooms so they designated bathrooms to cohorted patients in order to maintain separation. The trust had a backlog maintenance plan in place to repair or replace issues across [its] five sites. One of the key pieces of work was around replacing the flooring across Queen’s Hospital, Burton, which was under way, and large parts had been completed.
“Whilst on site, we found issues relating to the environment at Queen’s Hospital Burton.
“These included flooring coming up by the shower, loose plaster and a loose window pane.
“Following our inspection, two issues had been resolved and one had a planned date for completion.
“We saw commodes which had been cleaned and equipment being stored in bathrooms and shower rooms which were being used by patients.
“This posed an infection prevention control risk, as well as a potential falls risk to patients.
“On one occasion, commodes were being stored in a bathroom which had been used and not cleaned.
“This bathroom was cleaned after we pointed it out to the team.
“Following the inspection, we asked for risk assessments for the infection prevention control risks associated with the bathrooms being used as storage areas and the trust did not supply any information.
“However, following the factual accuracy process, the trust identified the storage of commodes within bathrooms was standard practice across the trust.”
Despite their criticism, inspectors praised Derby and Burton hospitals’ staff for their efforts during the Covid crisis.
Summarising, they wrote: “Leaders understood and managed the priorities and issues the service faced.
“They were visible and approachable in the service for patients and staff.
“The trust had a clear vision and strategy for continuously improving practices related to infection prevention and control and an action plan to meet identified goals.
“The action plan was aligned to local plans within the wider health economy.
“Staff were mostly aware of and understood their role in achieving the vision and infection prevention and control priorities. Staff felt respected, supported and valued. “The service had an open culture where staff could raise concerns without fear. They were focused on the needs of patients receiving care. “It was evident from speaking with staff that the challenges caused by the pandemic were both physically and mentally challenging, but they remained passionate about providing quality care to their patients.” The CQC’S visit came after, between October 5 and November 9, 373 patients and staff contracted Covid19 in the two hospitals.
In March, it was revealed 105 Burton and Derby hospital patients had died after contracting the virus while receiving care for other ailments.
When inspectors visited the hospitals in April, they found corridors blocked with trollies, meaning the one-way system aimed at reducing the spread of infections “could not be followed”.
They also found equipment being stored in bathrooms and shower rooms at Queen’s Hospital which were being used by patients. A “soiled” commode was found on a ward which had been labelled with an “I am clean” sticker.
On three occasions, inspectors saw staff not observing the signs dictating the number of employees allowed in a room at one time.
Staff in a “doctors’ mess” were not following social distancing and had also breached the limit on the number of employees allowed in one room.
Signs were up on each door marking the infectious status of each patient. However, inspectors found a “green/covid negative” sticker on the door of a patient who had the virus.
Staff said that changes in Covid guidance were often “open to misinterpretation, not heard or impacted by other factors such as staff fatigue”.
Leadership said they recognised the level of staff fatigue was a “challenge” and had been given a “major focus”.
Inspectors wrote: “The leaders of the trust told us being aware and open to this challenge was important and they were optimistic that as all the other systems created an improved picture, this would impact positively on staff fatigue and wellbeing.”
They have said the trust must not store equipment in bathrooms which are used by patients and should:
Ensure staff and patients are able to follow one-way systems and that corridors are not blocked
Ensure staff follow social distancing guidance and room limit signs
Ensure the correct signs are displayed showing a patient’s infectious status
Ensure commodes are consistently cleaned across the trust
The University Hospitals of Derby and Burton NHS Foundation Trust’s chief nurse, Cathy Winfield, said: “I’m really pleased with the report from the Care Quality Commission and it reflects the huge amount of work our staff have done over the past 15 months to prevent the spread of Covid-19.
“The report details that there are areas of good and outstanding practice that were noted, that the Trust had a clear vision and strategy for continuously improving practices related to infection prevention and that our staff understood their role in preventing infections.
“The report also highlights that our staff felt respected, supported and valued and that there is an open culture where they can focus on the needs of patients receiving care.”
One of the main infection prevention and control risks was the age and condition of the estates at Queen’s Hospital Burton