NHS trust handed warning notice after health watchdog inspects James Cook and Friarage hospitals

South Tees NHS Foundation Trust has been given a warning notice by a health watchdog.

It follows concerns raised about patient risk assessments, nutrition and unsafe discharges at two hospitals in our region.

The Care Quality Commission (CQC) carried out inspections at The James Cook University Hospital, in Middlesbrough, and the Friarage Hospital, in Northallerton, due to concerns raised by other health and social care organisations.

Inspectors looked at the quality of the environment and observed how staff were caring for patients.

The ratings for medical services and surgery at The James Cook University Hospital dropped from "good" to "requires improvement" while the rating for medical services at the Friarage Hospital remained as "good".

Following the inspection, South Tees NHS Trust was issued with a warning notice due to concerns about patient risk assessments, nutrition and hydration and unsafe discharges.

The overall trust rating remains unchanged, as "requires improvement".

The trust took immediate action and has already begun to make improvements.

At The James Cook University Hospital, CQC inspectors found:

• The service did not always have enough staff to care for patients and keep them safe.

• Staff did not consistently assess risks to patients and act on them or keep contemporaneous care records.

• Patients were not always safely discharged from the hospital.

However:

• Staff understood how to protect patients from abuse. The patient’s environments were safe, clean, and well maintained.

• Staff worked well together for the benefit of patients across multi-disciplinary teams.

• Staff treated patients with compassion and kindness.

At the Friarage Hospital, CQC inspectors found:

• The service did not always have enough nursing and support staff to care for patients and keep them safe.

• Medicines were not always well managed.

• Training did not reach the trust’s target.

However:

• Staff worked well together for the benefit of patients and supported people to make decisions about their care.

Sarah Dronsfield, CQC’s head of hospital inspection, said: “We saw on the trust’s own incident reporting system that the frequency and number of incidents where people had come to harm had increased over recent months.

"Other organisations had also voiced their concerns about these issues prior to the inspection.

“Despite asking the trust for evidence of learning and changes they had made as a result these incidents; we saw the same type of incidents reoccurring.

"We were therefore not assured that the trust was learning from its incidents and had strong systems in place to ensure that this happened."

Ms Dronsfield added that the trust leadership responded "promptly" to the inspectors' findings and outlined what action would be taken to address patient safety concerns.

The CQC will continue to monitor the service to "ensure the necessary improvements are made".

In response to the report, Dr Hilary Lloyd, chief nurse at South Tees Hospitals NHS Foundation Trust, said the findings were fully accepted and "experienced doctors and nurses acted immediately on inspectors’ initial feedback".

Dr Mike Stewart, chief medical officer at South Tees Hospitals NHS Foundation Trust, said: “As a clinically-led organisation, safety has been at the heart of our response to COVID-19 and the enormous work of all our teams has helped to achieve some of the lowest hospital infection rates in our region, which has saved lives.

"The measures required to maintain strong COVID-19 infection prevention for patients and service users – combined with the impact this winter’s record-breaking community infection rates had on our colleagues, with more than 500 COVID-related absences at the Omicron wave’s peak - meant that not every patient always had the experience we would want."

Dr Stewart concluded the trust "will continue to take forward the actions we need to make in response to inspectors’ feedback".

Andy McDonald, MP for Middlesbrough, praised staff at The James Cook University Hospital for their hard work during the "challenging covid crisis" and said it was "hardly surprising" the hospital had not made the progress hoped to be seen.

He added: "As demand on services is reduced, I would hope to see the measures already put in place continue and more improvements made. No-one wants to see standards fall."

The Labour MP said he would be meeting with the trust's chief executive to discuss the CQC report. The full report is published on CQC’s website. 

Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To know...