Source · CQC inspection

Weston Park Hospital

Provider Sheffield Teaching Hospitals NHS Foundation Trust Type NHS Healthcare Organisation Region Yorkshire & Humberside Last inspected 14 Nov 2018

Overall rating: Requires Improvement  View full CQC report

Domain ratings

Five CQC key questions
Safe
Good
Effective
Requires Improvement
Caring
Outstanding
Responsive
Outstanding
Well-led
Requires Improvement

Earlier inspection findings

pre-2024 framework · 14 must-do 27 should-do

Must-do actions (14)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 14
Must do
Well-led
The trust must ensure that all board members have been subject to all the appropriate fit and proper person checks and that these are recorded. In addition, the trust should comply with its own FPPR policy by ensuring that there is evidence of the qualitative assessment and values-based assessment directors had undergone as part of the recruitment process.
Regulation: Regulation 5 HSCA (RA) Regulations 2014 Fit and proper persons: directors
⚠ Whilst the Trust’s Fit and Proper Person Requirement (FPPR) policy was in date and met the requirements of the regulation we found that one director’s file we reviewed did not contain evidence that they had been subject to all the appropriate fit and proper person checks and none of the …
Must-do action 2 of 14
Must do
Well-led
The trust must ensure that there is effective oversight by the board of significant operational risks and how these are being managed.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ Whilst there were systems in place to manage risks the trust board did not routinely consider the most significant risks identified by care groups and directorates. In 2015 the trust had found a large cohort of patient pathways that had not been followed up and at the time of the …
Must-do action 3 of 14
Must do
Safe
The trust must ensure that there are named doctors for safeguarding in place and that the safeguarding policy for children is in date and reflects national guidelines.
Regulation: Regulation 13 HSCA (RA) Regulations 2014 Safeguarding service users from abuse and improper treatment
⚠ There was no named doctor for safeguarding and the safeguarding policy for children was out of date.
Must-do action 4 of 14
Must do
Safe
The trust must continue to ensure that its plans to manage the patient pathways in the outpatients follow up backlog are effectively, promptly and clinically assessed to ensure that no harm comes to patients.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ In 2015 the trust had found a large cohort of patient pathways that had not been followed up and at the time of the inspection there was still a backlog of over 25,300 patient pathways.
Must-do action 5 of 14
Must do
Effective
The trust must ensure the Mental Capacity Act and Deprivation of Liberty Safeguards are applied consistently and staff are aware of the relevant forms to complete and where to store and record this within the patient records.
Regulation: Regulation 11 HSCA (RA) Regulations 2014 Need for consent
⚠ There were not robust arrangements in place to support patients with mental health needs including managing and recording Deprivation of Liberty Safeguards and making sure that hospital managers discharged their specific powers and duties according to the provisions of the Mental Health Act 1983.
Must-do action 6 of 14
Must do
Safe
The trust must ensure the provision of 24-hour consultant medical cover within the emergency department as part of being a major trauma centre so that major trauma guidance is followed, and standards are achieved consistently.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Although we were informed that the trust was reviewing the requirements for the major trauma centre to include consultant staff 24 hours and seven days per week, we remained concerned that the major trauma standards were being breached and this had not been resolved in a timely way following our …
Must-do action 7 of 14
Must do
Safe
The trust must ensure action is taken to achieve the recognised standard of 15-minute arrival by ambulance to handover to the emergency department and to ensure breaches of the ambulance arrival standard are minimal.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ NHSEngland’s quality dashboard for June 2018 showed that for May 2018, the latest month for which comparative data was available at inspection, 11.1% of ambulance handover delays were for more than 60 minutes, which was worse than other trusts in the South Yorkshire area. Patients arriving by ambulance were not …
Must-do action 8 of 14
Must do
Safe
The trust must ensure standards of hygiene are maintained consistently in the emergency department, supported by correct handwashing in frequency and technique, equipment always being cleaned between patients and the availability of supplies and equipment to support appropriate cleaning of the department.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Standards of hygiene were not maintained consistently within the ED at NGH. We observed poor handwashing in frequency and technique. Equipment was not always being cleaned between patients. Some areas did not have cleaning wipes or cleaning liquids available.
Must-do action 9 of 14
Must do
Safe
The trust must ensure emergency department staff follow policy and best practice guidance for the prescription of oxygen therapy and the completion of patient records related to oxygen therapy.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ The emergency department did not consistently follow policy and best practice guidance for the prescription of oxygen therapy and the completion of patient records related to oxygen therapy.
Must-do action 10 of 14
Must do
Effective
The trust must have systems and processes in place to ensure best interest decisions and capacity assessments are recorded in patients’ notes.
Regulation: Regulation 11 HSCA (RA) Regulations 2014 Need for consent
⚠ We saw no evidence of any best interest decision making in any of the eight patient records we reviewed. During the inspection, we looked at the patient records of those who had been identified as having a learning disability. In the two patient files we reviewed at Northern General Hospital, …
Must-do action 11 of 14
Must do
Effective
The trust must have systems and processes in place, so all staff are aware of the escalation procedures if a patient appeals against their Mental Health Act section and requests an independent mental health advocate.
Regulation: Regulation 11 HSCA (RA) Regulations 2014 Need for consent
⚠ Staff told us on one patient who had wanted to appeal against their section and requested an independent mental health advocate, but the nurse was unable to identify to us how they would escalate this should the patient have to remain on the medical ward.
Must-do action 12 of 14
Must do
Well-led
The trust must further develop systems and process to ensure effective engagement and clinical support for junior doctors at Weston Park.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Junior doctors told us that securing physical presence of consultant oncologists on site was challenging. We raised this with the senior leadership team who said they were working on plans to address this, such as consultant of the week.
Must-do action 13 of 14
Must do
Well-led
The trust must have clear systems and processes in place to identify, manage, mitigate and escalate risk.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ There were not clear systems and processes in place to manage, mitigate and escalate risk.
Must-do action 14 of 14
Must do
Safe
The trust must ensure all staff at Northern General Hospital and Weston Park are compliant with medical device training.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Medical device training for the use of syringe drivers was lower than the trust plan at 66% and on some wards, there were no staff were compliant with the training.

Should-do actions (27)

Recommended improvements to enhance service quality.

Should-do action 1 of 27
Should do
Responsive
The trust should ensure the emergency department takes further action to achieve the Department of Health’s standard for emergency departments that 95% of patients to be admitted, transferred or discharged within four hours of arrival in accident and emergency.
Should-do action 2 of 27
Should do
Effective
The trust should ensure the emergency department has clearly sighted actions in place to improve door to antibiotic time for sepsis patients.
Should-do action 3 of 27
Should do
Safe
The trust should ensure the emergency department has clearly sighted actions in place to fully implement electronic patient record keeping without the need to maintain paper records for use in the department.
Should-do action 4 of 27
Should do
Well-led
The trust should ensure all clinical staff are fully conversant with the emergency department risk register and the trust board are appropriately sighted on the risks classed as ‘extreme’ by the emergency department.
Should-do action 5 of 27
Should do
Well-led
The trust should ensure the friends and family test and other means of patient and public engagement are further developed.
Should-do action 6 of 27
Should do
Safe
The trust should ensure the planned completion rate for mandatory training of 90% is achieved overall staff groups.
Should-do action 7 of 27
Should do
Effective
The trust should ensure the emergency department has clearly sighted actions in place to respond to the findings of both national RCEM audits and its programme of local audits.
Should-do action 8 of 27
Should do
Responsive
The trust should ensure health promotion information and materials are available in areas of the emergency department which are accessible to patients.
Should-do action 9 of 27
Should do
Caring
The trust should ensure drinks and snacks which represent healthy lifestyle choices and promote healthier options for patients and visitors are available in the emergency department waiting areas.
Should-do action 10 of 27
Should do
Safe
The trust should ensure the doors on ward E1 and E2 at Royal Hallamshire Hospital are fitted with appropriate locking mechanisms to help to keep patients and staff safe.
Should-do action 11 of 27
Should do
Effective
The trust should increase the availability of Mental Health Act specific training around detention under the Act to more staff.
Should-do action 12 of 27
Should do
Responsive
The trust should improve the experience for patients who need extra support, such as those living with dementia.
Should-do action 13 of 27
Should do
Safe
The trust should ensure secure access to medication at Northern General Hospital.
Should-do action 14 of 27
Should do
Caring
The trust should ensure the privacy of all patients is respected.
Should-do action 15 of 27
Should do
Safe
The trust should ensure stock is rotated.
Should-do action 16 of 27
Should do
Safe
The trust should ensure bowls are washed and dried at Northern General Hospital as according to best practice for infection prevention.
Should-do action 17 of 27
Should do
Safe
The trust should ensure carpets are removed from clinical areas at Royal Hallamshire hospital.
Should-do action 18 of 27
Should do
Safe
The trust should continue to reduce the movement of staff to clinical areas outside of their speciality at Royal Hallamshire Hospital.
Should-do action 19 of 27
Should do
Safe
The trust should ensure all treatment rooms at Royal Hallamshire hospital have lockable doors that are not propped open.
Should-do action 20 of 27
Should do
Effective
The trust should ensure they use available data to evidence positive, or implement actions to improve, patient outcomes.
Should-do action 21 of 27
Should do
Safe
The trust should ensure all staff meet the trust’s own target for mandatory training compliance.
Should-do action 22 of 27
Should do
Safe
The trust should ensure staff at Northern General Hospital and Weston Park are able to access pressure relieving mattresses in a timely manner, to enable them to safely care for patients at risk of pressure damage.
Should-do action 23 of 27
Should do
Caring
The trust should improve the mortuary facilities to prevent deceased patients being taken outside the building and through a public area.
Should-do action 24 of 27
Should do
Safe
The trust should ensure the frequency of environmental and infection prevention and control audits conducted on the Macmillan palliative care unit matches the frequency identified by the trust.
Should-do action 25 of 27
Should do
Effective
The trust should ensure patients’ care at Weston Park is planned in line with the trust’s end of life care guidelines.
Should-do action 26 of 27
Should do
Effective
The trust should ensure it has robust document control processes in place at Weston Park to prevent the use of out of date guidance.
Should-do action 27 of 27
Should do
Responsive
The trust should consider further improvements at Weston Park to support individual patients, for example those living with dementia.

Location details

CQC ID: RHQWP
Local authority: Sheffield
Region: Yorkshire & Humberside

Inspection report

Type: Location
Date: 14 November 2018
Rating: Good
Actions: 14 must-do 27 should-do
AI-extracted 3 Jun 2026