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CQC requires improvement at Liverpool Community Health NHS Trust.

The Care Quality Commission has told Liverpool Community Health NHS Trust that it must make improvements to comply with national standards of quality and safety.

This follows unannounced inspections at the Trust’s Headquarters site to review the Trust’s district nursing and community equipment services and at Ward 35 Intermediate Care Unit. The visits took place in November and December 2013 and the reports of the inspections are published recently.

The inspections were carried out in response to concerning information reported to CQC. Inspectors found the Trust was failing to meet national standards relating to care and welfare; staffing; supporting workers and assessing and monitoring the quality of service provision.

In addition, shortfalls were identified in relation to the accessibility of equipment in the district nursing and community equipment services, and the management of medicines on Ward 35 Intermediate Care Unit.

In the district nursing services inspectors found a lack of detailed handover information about patient care and a high reliance on agency staff.

Inspectors were concerned that high staff sickness rates and poor staff skill mix could impact on the Trust’s ability to ensure that patients’ needs were fully met.

There was a lack of clinical supervision taking place in the district nursing service and not all staff had received up to date mandatory training. Some staff told inspectors that they felt unsupported by Trust managers and that staff morale was low.

On Ward 35 staff reported that that patients had been admitted with needs more complex than was set out in the ward admission criteria. Inspectors raised concerns that staff may not be able to fully support those patients with more complex needs.

Inspectors observed staff did not always follow safe practice when administering medication and not all medicines were stored securely.

Serious concerns were raised by staff that they would be treated unfairly should they report incidents or concerns to management. At both sites inspectors saw Trust wide systems for monitoring service quality were in place, but these were not consistently followed, and were not sufficiently robust to ensure all risks were identified and managed effectively.

As a result of the inspection, CQC has issued two formal warnings to the Trust, requiring improvements in the assessment and monitoring of the quality of service provision and supporting workers. The Trust has also been told that action is required to address all other areas of non-compliance identified.

Inspectors will return to the Trust, unannounced, to check that the necessary improvements have been made.

Malcolm Bower-Brown, CQC’s Regional Director for the North said:

“Undertaking unannounced inspections in response to information of concern is a vital part of CQC’s role.

“The shortfalls we found against legally required national standards were extremely concerning. We have warned Liverpool Community Health NHS Trust that urgent improvements must be made.

“We are monitoring the Trust carefully, working closely with the NHS Trust Development Authority and other agencies, to ensure all the required improvements are made.

“In the meantime, anyone who is concerned about the standard of care in any registered service should not hesitate to contact us.”

For further information please contact the CQC Regional Communications Team, David Fryer 07901 514 220 or Kirstin Hannaford 0191 233 3629.

For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

NOTES TO EDITORS

CQC has published the full reports at both locations:

Ward 35 Intermediate Care Unit

Liverpool Community Health NHS Trust

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.