Clatterbridge Hospital

⚠ People could not always access the service when they need it and referral to treatment times were consistently below the national average. The service did not discharge patients in a timely way and did not minimise the number of patient moves between wards at night. There were not effective arrangements …

⚠ People could not always access the service when they need it and referral to treatment times were consistently below the national average. The service did not discharge patients in a timely way and did not minimise the number of patient moves between wards at night. There were not effective arrangements …

⚠ ED doctors did not have the authority to make a decision to admit to medical or surgical specialties, which led to lengthy delays to patient care.

⚠ There was a lack of privacy and dignity for patients being cared for in the emergency department corridors. Patients were accommodated in these areas for extended periods of time and staff carried out examinations without access to privacy screens.

⚠ The service did not always control infection risk well. The service had an outbreak of clostridium difficile in 2019. Not all equipment and areas of the premises were kept visibly clean. Infection control practitioners were not always consulted when decisions were made to open wards with a known infection outbreak …

⚠ Some areas and equipment were not properly maintained or fit for purpose. We found out of order toilets and bathrooms in four wards. Oxygen was not stored securely in line with manufacturer guidance on four wards.

⚠ The use of the discharge lounge did not maintain patient confidentiality. Confidential paperwork was left on desks and confidential telephone conversations took place in the bay area.

⚠ Staff did not consistently complete and update risk assessments for each patient. They did not always share key information to keep patients safe when handing over care to others or complete risk assessments when patients moved wards.

⚠ Staff did not always share key information to keep patients safe when handing over care to others or complete risk assessments when patients moved wards. Ward 25 did not have dedicated doctors as all patients were considered medical outliers.

⚠ Although the trust had a system for tracking and monitoring deprivation of liberty safeguards and when they expired, this was not robust as information was not always shared with appropriate staff in a timely way.

⚠ People could not always access the service when they need it and care and treatment was not always provided promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were consistently lower than national standards. Patients were not always discharged as quickly as they should …

⚠ People could not always access the service when they need it and care and treatment was not always provided promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were consistently lower than national standards.

⚠ Leaders and teams did not always use systems to manage performance effectively. Staff could identify risks for the service, but there was little local ownership of risks and actions. Actions identified in the risk register did not always fully mitigate the risk or risks were not acted on in a …

⚠ Staff did not always comply with the requirements of the surgical safety checklist and so were not minimising risks in this area.

⚠ The service did not always control infection risk well, with staff not always using control measures to protect patients, themselves and others from infection. The service had systems to identify surgical site infections, albeit that it was undertaking the minimum requirements.

⚠ The design of the pre-operative facilities did not meet the needs of patients or staff.

⚠ People could not access the service when they need it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were not in line with national standards. There were a high number of cancelled operations which were not rescheduled within …

⚠ The service did not comply with the child protection information sharing standard designed to safeguard children who were looked after or in protection.

⚠ Staff did not complete updated nursing risk assessments for each child and young person and there was no designated mental health assessment provision for children outside of office of hours. This meant staff could not effectively identify children and young people at risk of harm or deterioration.

⚠ The service did not always control infection risk well. The service did not follow trust standard operating procedures for the decontamination of flexible nano-optic endoscopes. We found opened endotracheal tubes in the airway management tray on the ophthalmology resuscitation trolley which were removed during our inspection.

⚠ In the ophthalmology department the flooring in one of the clinic rooms was in a very poor condition, it was cracked and peeling.

⚠ The service did not have a policy or standard operating procedure for the management of MRI induced burns.

⚠ The diagnostic imaging services did not always provide care and treatment, or manage facilities, in line with good governance principles around evidence based practice.