Loyal staff and happy patients is what a team of inspectors found when they visited Darent Valley Hospital, according to a report published today.
In his first report on services provided by Dartford and Gravesham NHS Trust at the Dartford hospital, England’s Chief Inspector of Hospitals, Professor Sir Mike Richards, found that most services were good and patients were positive about their experiences.
In his report for the Care Quality Commission, Professor Richards said: “We found that most of the services at Darent Valley Hospital were good.
“The majority of patients told my team that they were happy with the care and treatment that they had received, and we identified a number of examples of good practice.
“Overall, we found a culture where staff were positive, engaged and very loyal to the organisation, and the staff and management at the hospital were open and transparent about the challenges they faced.
“We did, however, find a number of fairly basic areas in which the trust needed to improve.
“We’d expect people’s privacy and dignity to be respected at all times, and for people to always be cared for in an environment that is designed to meet their needs, by an appropriate number of staff.
“We acknowledge that the trust faces big challenges in its A&E department, and that finding a solution to these challenges is going to involve a joined up approach by the wider health economy. We hope the necessary steps will be taken to deliver a better service to local people.”
The inspection team found a number of examples of good practice and shared learning but in some cases the lessons from serious incidents took up to 12 months to implement.
The trust had taken action in some places where staffing was an issue, and increased the number of nursing staff, midwives and pharmacy department porters.
It was noted the trust faced significant challenges, most notably in Accident and Emergency (A&E) where admissions had increased due to a reduction in other local services. While issues were being managed on a day-by-day basis, they were not solving the key underlying problems, in particular bed management and capacity, and inappropriate attendance at A&E.
Also in A&E, there were not enough nurses qualified in the care of children and there was a high use of locum middle grade doctors, which had the potential to impact on patients’ safety.
Inspectors found the acute assessment wards were mixed sex at times which could compromise patients’ dignity.
The CQC has told the trust it needs to improve in a number of areas, including:
• Ensuring the required number of correctly skilled staff are employed and managed shift by shift.
• Making sure that patients are treated with dignity and respect at all times, especially in the operating department.
• Respecting patients’ privacy and right to confidentiality at all times, particularly in A&E.
• Ensuring that at all times patients are cared for in a safe environment that is designed to meet their needs.
• Ensuring that lessons learned from the reporting of incidents is fed down and any necessary changes after a serious incident are implemented in a timely manner.
• Taking action to ensure that good practice guidance is being considered and used in all areas, particularly A&E.
On a positive note, the CQC found:
• An integrated discharge team had been introduced to help with the safe, effective and timely discharge of patients.
• The number of midwives had been increased and improvements made to the maternity unit.
• The hospital’s bed management meetings were multidisciplinary and included executive team members and ward sisters.
• End of life care was safe, effective, caring, responsive and well led.
• There was a positive approach to managing the needs of people with dementia.
• A code of conduct for nursing assistants had been developed and launched.
The inspection team – which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts – spent two days at the hospital in December. They examined the care provided in A&E, medical care, surgery, intensive care, maternity, children’s care, end of life care and outpatients.
In another visit, they turned up unannounced and also met with staff and members of the public.
CQC inspectors will return to Darent Valley at a later date check how the trust is progressing in making required improvements.