Southport & Formby District General Hospital Requires Improvement

Date of CQC publication 18/09/2018

CQC did not re-rate urgent and emergency care at the time of this inspection. We found the following areas for improvement:

• We had concerns about the safety of patients in the department. This was for a number of reasons. The department did not have enough capacity to accommodate all the patients requiring treatment.
• Patients waited a long time to receive medicines such as pain relief. Handover, initial assessment and responsibility for patients was not happening in a timely manner. Ambulance staff were waiting with patients for excessively long times in the department.
• Records were not completed in a comprehensive way and risk assessments were not documented as being carried out.
• Infection prevention and control practices were not following national guidance: staff were not always washing their hands, using gloves appropriately or arms bare below the elbow. The department was not always as clean as it should be with dirty rooms and smears of bodily fluids on walls.
• There were insufficient staff deployed to the department and from the evidence we looked at, this had been a long-term issue.
• Staff were not up to date with their mandatory training.
• We had concerns about the responsiveness of the department. It was not able to meet the demand from the number of patients attending. The department had severe problems with capacity.
• The hospital was also full to capacity and as a result, emergency department patients were waiting for long periods of time in corridors before being admitted to wards. There was poor flow through the department on to wards and from wards home. From what we saw and what staff told us, the whole flow of the system did not appear to be working well.
• The department was performing poorly against national government performance indicators such as waiting time targets. This meant patients did not have access to treatment and care in a timely manner.
• There was no system of data validation in place to ensure waiting time information was accurately reflecting the time patients spent in the department.
• Escalation processes in place were not effective and patients were waiting excessive time in the department as a result.

However:

• Staff were working extremely hard to deliver care that was caring and compassionate under very difficult circumstances.
• We observed staff helping patients and supporting them as best they could.
• Nursing and medical staff worked well together and were doing the best they could for patients.