A SHOCKING new report on an investigation and inspection by the Care Quality Commission (CQC) has found Basildon Hospital is in urgent need of improvement and has reached a new low in terms of service to the region's public.

And fellow hospitals operated by the Mid and South Essex NHS Trust, at Southend and Basildon, have been similarly damned in reports released today (Friday, 16 June).

All three hospitals have significant issues relating to waiting times, equipment, and a lack of nursing and support staff.

CQC inspectors said that "people were not always safe because staff did not always complete and update risk assessments", as well as raising the concern that "people could not access the service when they needed it".

Following the inspection - in January and February - all three hospitals are now rated as "inadequate" for medical care, the worst of the four possible ratings, a drop from the previous rating of "requires improvement".

Basildon Hospital

They are also rated "inadequate" for being safe, effective and well-led. Responsiveness and caring were inspected but not rated at this time.

The inspection of medical care has affected the overall rating of both Basildon and Broomfield, which have now dropped to "inadequate" as have their ratings for safety, effectiveness and how well-led they are.

Southend Hospital remains rated as "requires improvement" and the Trust itself remains rated as "requires improvement" overall.

The report on Basildon Hospital can be viewed in full via this link.

A summary of services at the hospital shows a significant number of negative reports but there are some positives.

CQC says: "We rated it as inadequate because":

• Not all staff had completed mandatory training including safeguarding training.

• The maintenance and use of facilities, premises and equipment did not always keep people safe.

• Staff did not always complete and updated risk assessments for each patient to remove or minimise risk. Staff did not always keep detailed records of patients' care and treatment. Records were not always clear or up-to-date or secure. The service did not always use systems and processes to safely prescribe and administer medicines.

• The service did not always have enough nursing and support staff. Managers regularly reviewed and adjusted staffing levels.

• Documentation of mental capacity assessment were not always decision specific.

• Staff did not always respect patients privacy and dignity.

• People could not access the service when they needed it and waiting times from referral to treatment and arrangements to admit and treat patients were not in line with national standards.

• We were not assured that governance systems and processes were effective in relation to staff complying with internal quality standards, improving patient care, or patient outcomes.

• We were not assured service systems and processes for identifying, recording and managing risks and performance were effective.

However:

• The service-controlled infection risk well. They kept equipment and the premises visibly clean.

• Staff recognised and reported incidents and near misses. Managers and trained clinicians investigated incidents and shared lessons learned.

• Staff treated patients with compassion and kindness, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.

• The service made sure staff were competent for their roles. Managers appraised staff's work performance.

Hazel Roberts, CQC deputy director in the east of England, said: "Following our inspection of medical care at the Mid and South Essex NHS Foundation Trust we found a leadership team who didn't have complete oversight of the issues they're facing.

"We've highlighted a number of issues where they need to have far better oversight and where we want to see significant improvements. This includes making sure people are able to access the service when they need it, and that there are enough, trained staff to care for them safely.

"Leaders need to ensure they are allowing staff the time to complete essential training, including safeguarding and conflict resolution. This helps staff to understand and look out for risks and how to deal with them. Without this training, staff weren't always able to complete and update risk assessments for each person to remove or minimise these risks.

"It was also disappointing that people's privacy and dignity wasn't always respected. We found areas in all three hospitals where a ward at full capacity didn't have curtains or screens to provide privacy and dignity to every person occupying a bed.

"During the inspection we did see staff mostly treating people kindly and with care. However, we also saw in some areas, staff didn't always support people to make informed decisions about their care and treatment. Especially when the person lacked capacity to make their own decisions or was experiencing a severe mental health crisis.

"We are aware the local integrated care system is supporting the trust, as are NHS England and they should use this additional expertise and resource to make the rapid improvements that we need to see. Leaders also need to listen to staff who are in the best position to help implement the changes needed to ensure these improvements are embedded.

"We have fed back our findings to the trust leadership team who were fully aware of what they need to do to make and embed the improvements needed. We will re-inspect to ensure improvements are being made and won't hesitate to take further action if needed to protect people."

Hannah Coffey

"We are an organisation committed to quality improvement, and to providing the best possible care for our patients. We are disappointed that, while there are no other services apart from medicine rated as inadequate at any of our hospital sites, the algorithm used by the CQC means that they have now rated Broomfield and Basildon Hospitals as inadequate overall.

"In the five months since we were inspected, significant improvements have been made to inpatient environments and we are supporting nutrition and hydration by recruiting more feeding buddies to work with patients at mealtimes. We have also introduced a Nutrition Charter for patients and brought in protected mealtimes.

"There has been a real focus on getting the basics right – which is already leading to improvements in care. We are offering personalised training for our staff, and have seen a significant reduction in staff vacancies and turnover.

 "We know we have a lot to do to improve the ratings for medical services and are absolutely committed to this work. We are very clear about what needs to be done and confident we can build on the positive changes already made to get the basics right every time, for every patient."