The York Hospital
- Regulation
- —
- Date
- 02 Jul 2025
At the last assessment the service was in breach of the legal regulations relating to person centred care and safeguarding.
Regulatory breaches and the formal action the Care Quality Commission took on them, as named in CQC Single Assessment Framework assessment commentary from 2024 onward. CQC publishes no separate machine-readable enforcement register, so each record is the breach statement quoted verbatim from the assessment and classified by the action stated there. A letter of intent is recorded separately from urgent action, so an action CQC is only considering is never shown as one already taken.
Coverage: England. Regulatory breaches and the formal action taken on them, named verbatim in CQC Single Assessment Framework assessment commentary from 2024 onward. Scoped to NHS-trust locations by default, so it is not a complete record of CQC enforcement across the whole regulated estate.
Newest content date: 4 Sep 2026. This describes the content held here, not the date this page was opened.
Records written on 4 of the last 90 days; last write 6 Sep 2026.
Publisher's stated schedule: Continuous. That is the publisher's own description, not a measurement of this copy.
At the last assessment the service was in breach of the legal regulations relating to person centred care and safeguarding.
Whilst the service had improved in a number of places since the last assessment at this assessment we still found breaches of legal regulations.
We issued a Section 29A Warning Notice under the Health and Social Care Act 2008.
Improvements were not found at this assessment, and the service remained in breach of these regulations.
The service was previously in breach of the legal regulations in relation to mandatory training and safeguarding service users from abuse and improper treatment.
The service remained in breach of previous legal regulations concerning mandatory training and safeguarding, as well as new breaches related to staffing, consent, premises and good governance.
We found 3 breaches of Regulation 12, Safe Care and Treatment and 2 breaches of Regulation 17, Good Governance.
A number of nursing staff were carrying out additional bank shifts in other areas of the trust triggering European Union working time directive breach notifications.
This resulted in a breach of regulations in relation to safe care and treatment.
We raised this concern with the trust through a letter of intent to take further action.
Following our inspection, we issued the service with a warning notice in regard to staffing.
Therefore, there was a risk of harm to babies with complex needs. > We raised these concerns with the trust through a letter of intent to take further action regarding the St James University Hospital Neonatal service provision.
Following our inspection, we issued the service with a warning notice in regard to staffing.
The service was in breach of regulations relating to managing risk, staffing, safe environments, infection prevention and control and medicines management.
We found breaches of regulations relating to; learning following incidents, risk management, safe environment, infection prevention and control, medicines management and some governance processes.
The service was in breach of regulations relating to managing risk, staffing, safe environments, infection prevention and control and medicines management.
The service was in breach of the legal regulation relating to learning following incidents, risk management, safe environment, infection prevention and control, medicines management and some governance processes.
We issued two Requirement Notices.
During this inspection, we looked at 3 quality statements and reviewed the breaches of regulation from the last inspection.
The service was in breach of the legal regulations in relation to, safe care and treatment and good governance.
However, we found they were in breach of different areas of good governance (assessment and monitoring of the service).
The service was previously in breach of the legal regulation in relation to safe care and treatment (assessment of venous thromboembolism risk) and good governance (secure storage of patient records).
In response to the warning notice, the trust provided an action plan that included revising the SAU’s standard operating procedure, introducing regular safety huddles, and enhancing escalation pathways for addressing delays in patient care.
These issues were highlighted in the warning notice issued, which called for immediate action to address deficiencies in the management of the SAU, as well as systemic concerns regarding patient safety and dignity.
Since the warning notice was issued, the trust provided additional evidence of its efforts to address these concerns.
The Care Quality Commission issued a warning notice following the inspection, detailing specific areas for urgent improvement, including deficiencies in patient flow, the management of the Surgical Assessment Unit (SAU), infection control protocols, and medicines management.
We found a breach in the HSCA 2008 Regulated Activities in Regulation 12, Safe Care and Treatment and issued the provider with a Section 29A warning notice.
We found 2 breaches of the legal regulations in relation to safe care and treatment and governance.
Continued breaches were; medical staff training compliance, timely data submission to external bodies, leadership, poor culture within the service and the absence of a fully operational governance team.
The provider was now in breach of regulation in relation to staffing.
The provider remained in breach of the legal regulation in relation to safe care and treatment and governance.
At this assessment, we found 3 breaches of regulation.
We issued an action plan request in relation to breaches of regulation found relating to safe care and treatment (for patients assessed and/or treated by the mental health team) as well as concerns relating to governance.
However, we found 2 breaches of the legal regulation.
We found breaches of regulations relating to safe care and treatment, good governance, and staffing.
We found one breach of regulations in relation to infection prevention and control.
Areas for improvement Action we have taken: We found the following breaches of regulation.
Along with the warning notice issued for failures in governance, we have issued requests for action plans against a number of regulations.
The Section 29a Warning Notice has given the trust until 31 December 2024 to rectify the areas for significant improvement we identified.
As a result of our assessment, we issued the trust with a Section 29a Warning Notice as significant improvements were required in relation to governance.
We found two breaches of regulations relating to safe care and treatment and staffing.
Following this assessment, we found the warning notice had been met and maternity was rated good overall.
We last assessed maternity services at Tunbridge Wells Hospital, Pembury in 2023, and it was rated to inadequate, and we served a warning notice.
We found 1 new breach of the legal regulation safe care and treatment under the key question safe.
We found significant improvements during this inspection and the trust have met their Section 29a Warning Notice requirements.
This assessment was a focused follow up inspection following a section 29a Warning Notice back in 2023.
The trust have met their section 29a warning notice and have made significant improvements since our last inspection.
We found a breach of regulation for safe care and treatment in the safe, effective and responsive domains.
| Category | Value |
|---|---|
| Regulatory breach | 402 |
| Requirement notice | 13 |
| Warning notice | 114 |
| Condition of registration | 2 |
| Letter of intent | 10 |
| Urgent enforcement | 8 |
The chart shows the mix of formal actions named across the loaded records.
Contains public sector information licensed under the Open Government Licence v3.0.