Hospital orders improvements after health watchdog inspection

Care Quality Commission inspectors visited the hospital this summer specifically to investigate the way children in the urgent and emergency care service were treated, along with adults needing some types of assistance with breathing - such as those needing oxygen via a face mask.

They found problems in both areas, though they are now satisfied hospital managers have taken sufficient steps to address the issues over children's care by this month and over the ventilation treatment by November.

The CQC have published a report into their findings, which states they found: 'There was insufficient escalation and management of the deteriorating child, and a lack of oversight and governance of the risks to children within the paediatric (children's) urgent and emergency care service.

'There were three serious incidents that highlighted a lack of clinical oversight, poor medicines management and delayed diagnosis and treatment of children in the urgent and emergency care services.

'There was no paediatric-specific training for staff or competency assessment in place for sepsis or diabetes /diabetic ketoacidosis(DKA).

'Staff did not routinely use Paediatric Early Warning Scores (PEWS) on all children attending the department.'

Other shortcomings were also highlighted, with the Trust providing a detailed response cataloguing changes to be put in place by this month, satisfying inspectors who said: 'This showed that sufficient actions had been planned to address the immediate risks to patient safety within the service.'

In addition, a paediatric '˜task and finish' group was set up to oversee improvements and act on immediate risks to children.

Inspectors also looked at the way ventilation assistance was given to patients and their visit revealed: 'There was insufficient management, oversight and governance of the risks to acute non-invasive ventilation patients admitted at the hospital.'

Services were not provided in line with medical guidelines, with staffing levels among nurses not always enough to meet the needs of the patients they were caring for.

Records for in-patients 'contained errors and omissions and showed evidence of delayed escalation and delayed or missed observations', said the report.

'Patients did not always have a specialist consultant review within 14 hours of admission and patients did not have a daily consultant review thereafter,' it said.

A change introduced by the hospital means now all patients receiving such treatment will be on a high dependency unit, ensuring their care was provided by appropriate staff.

Normally, CQC inspections result in new gradings being issued, but because this summer's inspection looked only at specific areas that did not happen.