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Wiltshire Primary Care Trust not meeting 11 essential standards.

The Care Quality Commission has told the NHS in Wiltshire that it must improve standards of care at Chippenham Community Hospital.

CQC inspectors who visited the hospital in December found significant variations in the services provided.  While women on the Chippenham Birthing Unit reported high satisfaction with their care – there were some concerns with other services provided by the hospital.

The report which is published today says that overall, the hospital is not meeting 11 of the essential standards of quality and safety.     

Wiltshire Primary Care Trust has now been given 28 days to provide plans to show how it will meet essential standards of care across Chippenham Hospital as a whole.   These are the standards people should be able to expect when they receive care and providers now have a legal responsibility to meet them.

Inspectors looked at the hospital environment, spoke to patients and staff on two wards and in the minor injuries unit, and reviewed a range of information.  

In the maternity unit, new mothers praised the staff for their patient support with breastfeeding, and in the minor injuries unit staff were described as cheerful and welcoming.     

But on Beech ward, the stroke rehabilitation unit, inspectors found that there was a need to make a range of improvements:  

Respecting and involving people who use services: The report says that staff do not always treat patients with dignity and respect. People told inspectors that they did not feel able to raise concerns in case this affected their ongoing care and treatment. One person reported feeling belittled by staff because she had been unable to perform a basic task, and inspectors saw patients on the stroke unit struggling to eat their meals because staff were not paying them enough attention.

Care and welfare of people who use services: The inspectors reported that patients generally received appropriate treatment and care. Few people develop pressure sores, infections or blood clots whilst staying at Chippenham Hospital, which also receives few complaints. But on the stroke unit, too many people have had falls, and inspectors were not satisfied that the risks to people were always assessed promptly, reviewed, or acted on. The standard of record-keeping was also variable.

Management of medicines: Inspectors were also concerned about the management of medicines:  While there were systems in place to ensure safe practice, these were not always followed by staff. Inspectors who observed a medication round were concerned that the nurse was easily distracted, thereby increasing the risk of medication errors.  Inspectors were also not satisfied that people knew about or understood their medication.

Staffing and training: Inspectors felt that staffing levels and staff training were at the root of many of their concerns. They were told that staff sickness levels had been high and some staff did not feel that enough was done to ensure that there were enough suitably qualified nurses on duty, causing stress and affecting morale. Inspectors were also concerned that a significant number of staff were not up to date with essential training.

Ian Biggs, Regional Director of CQC in the South West said that his staff would follow up this review later this year to ensure that the necessary improvements are made.

He said:  “This report shows that if you don’t invest in your staff and ensure that they are properly supported, trained and managed, then the care that people receive will fall below required standards.  This situation must be resolved quickly so that people are cared for properly and can have confidence in the staff who look after them.

“It is clear that there are aspects of the service at Chippenham Hospital which are of a high standard, and many of the patients we met appreciated the care they received. I am satisfied that Wiltshire Primary care Trust has acknowledged the issues we identified and is now responding to the problems that we found,  but we need to be certain that the improvement is sustained, and we will, of course, keep a check on the hospital’s progress.”

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

• The full report on Chippenham Community Hospital is available here

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. Our aim is to make sure that better care is provided for everyone, whether it is in hospital, in care homes, in people’s own homes, or anywhere else that care is provided. We also seek to protect the interests of people whose rights are restricted under the Mental Health Act. We promote the rights and interests of people who use services and we have a wide range of enforcement powers to take action on their behalf if services are unacceptably poor.

We are introducing a new regulatory system that brings the NHS, independent healthcare and adult social care under a single set of essential standards of quality and safety for the first time. We register health and adult social care services if they meet essential standards, we monitor them to make sure that they continue to do so and we respond quickly if there are concerns that standards are not being maintained.  We rely on people who use services and those who care for and treat them to tell us about the quality and safety of services. This feedback is a vital part of our dynamic system of regulation which places the views, experiences, health and wellbeing of people who use services at its centre.