The Care Quality Commission (CQC) carried out inspections of medical care and urgent and emergency services at The Ipswich Hospital in September last year. CQC has lowered the rating for medical care from good to requires improvement. It has again rated urgent and emergency services requires improvement.
The Ipswich Hospital is run by East Suffolk and North Essex NHS Foundation Trust. Inspectors carried out this visit to follow up on issues raised at previous inspections and in response to specific concerns people raised to CQC.
Following this inspection, inspectors served the trust a warning notice due to concerns about people’s safety and the management of these services.
- CQC has lowered medical care from good to requires improvement for responsive and well-led. Inspectors again rated it requires improvement for safe. This inspection didn’t examine effective or caring, so these remain rated good from a previous inspection.
- CQC has again rated urgent and emergency care requires improvement for safe, responsive, and well-led. This inspection didn’t examine effective or caring, so these remain rated good from a previous inspection.
- The Ipswich Hospital as a whole remains rated requires improvement.
Carolyn Jenkinson, CQC deputy director of hospitals in the East of England, said:
“When we inspected The Ipswich Hospital, we found staff were kind and working hard to meet people’s needs under high pressure, but weren’t always able to do so safely.
“Staff weren’t able to triage everyone arriving at the emergency department within their goal of 15 minutes, and some people waited up to 20 hours to be treated or admitted to the medical wards. During this time, staff didn’t always monitor them closely enough to keep people safe from risks of deterioration.
“When people were admitted, staff couldn’t always place them on the most appropriate ward, as there wasn’t enough capacity. This was partly because staff on the medical wards were struggling to discharge people who were ready to leave the hospital but couldn’t, such as for those awaiting social care from other organisations.
“Additionally, there was a shortage of staff on the medical wards, which could further impact people’s safety and staff morale. Some risks to people’s safety, such as care records missing details, weren’t being thoroughly managed in either department.
“While more work is needed, leaders acknowledged the issues we identified and were working to address many of them, such as through a new electronic record system.
“Despite the pressures on the hospital, people we spoke to said staff listened to them and treated them with kindness and empathy. We saw staff offering hot drinks to people waiting in the emergency department and helping someone install new batteries for their hearing aids.
“We’ve shared our findings with the trust and will closely monitor these services to ensure people are kept safe while improvements are made.”
Inspectors found:
- Staff didn’t always document mental capacity assessments clearly or understand how to respect the rights of people with limited mental capacity.
- Staff in emergency care didn’t clearly record some people giving informed consent to care, meaning inspectors couldn’t confirm this took place.
- Staff didn’t always inform people clearly about details of their care, such as wait times, potential treatments, or when they might be discharged.
- Leaders hadn’t ensured all staff were up to date on training, including in safeguarding.
- Staff didn’t always mark newly cleaned equipment, and some didn’t always wash their hands between caring for people, which could spread infection.
- While staff did meet people’s nutrition needs, most people on the medical wards told inspectors they didn’t like the food.
- Some managers had been recently appointed to their roles and the leadership wasn’t always monitoring people’s outcomes well.
However:
- People said the emergency department was clean and calm, although the public waiting room could become crowded at times.