Source · CQC inspection

Corbett Hospital

Provider The Dudley Group NHS Foundation Trust Type NHS Healthcare Organisation Region West Midlands Last inspected 12 Jul 2019

Overall rating: Inadequate  View full CQC report

Domain ratings

Five CQC key questions
Safe
Inadequate
Effective
Good
Caring
Good
Responsive
Good
Well-led
Inadequate

Earlier inspection findings

pre-2024 framework · 54 must-do 52 should-do

Must-do actions (54)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 54
Must do
Safe
The trust must ensure that there are robust escalation and full capacity protocols in place aimed at avoiding a crowded emergency department and that they are followed in times of high demand.
⚠ Risks within the emergency department were not always identified and escalated appropriately. We were not assured that all patients allocated to wait on the corridor were safe.
Must-do action 2 of 54
Must do
Safe
The trust must ensure that all patients in the emergency department are subject to the same safety checks.
⚠ Risks were not always identified and escalated appropriately. We were not assured all patients allocated to wait on the corridor were safe.
Must-do action 3 of 54
Must do
Responsive
The trust must ensure that ambulance crews are able to handover the care of their patients as soon as they arrive at the emergency department.
⚠ People could not always access the service when they needed it. Waiting times for treatment and arrangements to admit, treat and discharge were not in line with best practice.
Must-do action 4 of 54
Must do
Safe
The trust must ensure that all staff within the emergency department complete mandatory training and additional training for their role as per trust policy.
⚠ The service provided mandatory training in key skills to all staff however they did not make sure that everyone completed it. The trust’s mandatory training target was met by nurses for five of the ten modules while doctors only reached compliance on one.
Must-do action 5 of 54
Must do
Safe
The trust must ensure that all staff in the emergency department are trained in and to the appropriate levels of safeguarding for adults and children.
⚠ Weekly data provided by the trust showed that paediatric liaison forms and multi-agency referral forms were not always completed where appropriate so we were not assured that safeguarding knowledge was applied correctly at all times and they knew how to apply it.
Must-do action 6 of 54
Must do
Safe
The trust must ensure that patients being cared for on corridors are appropriately supervised at all times.
⚠ Risks were not always identified and escalated appropriately. We were not assured that all patients allocated to wait on the corridor were safe.
Must-do action 7 of 54
Must do
Safe
The trust must ensure that all required patients presenting to the emergency department receive a robust clinical assessment in line with national guidelines and standards within 15 minutes of arrival.
⚠ The trust currently has a condition on its registration for the treatment of disease, disorder and injury to ensure that an effective system is in place to robustly clinically assess all patients who present to the emergency department in line with relevant clinical guidelines within 15 minutes of arrival. We …
Must-do action 8 of 54
Must do
Safe
The trust must ensure that patients with deteriorating conditions are effectively identified and treated within the emergency department.
⚠ The trust currently has a condition on its registration for the treatment of disease, disorder and injury to ensure there is an effective system to identify, escalate and manage patients who may present with sepsis or a deteriorating medical condition in line with the relevant national clinical guidelines, which applies …
Must-do action 9 of 54
Must do
Safe
The trust must ensure the appropriate storage, checking and administration of medicines at all times within the emergency department.
⚠ The service did not always follow best practice when prescribing, giving, recording and storing medicines.
Must-do action 10 of 54
Must do
Safe
The trust must ensure that all staff within the emergency department understand their responsibilities in supervising mental health patients and have the skills, training and competency to do so.
⚠ Most staff were competent for their roles. However, mandatory training compliance was low and some staff did not have full understanding of key areas of their role.
Must-do action 11 of 54
Must do
Safe
The trust must ensure that risks within the emergency department appropriately identified and managed.
⚠ Risks were not always identified and escalated appropriately.
Must-do action 12 of 54
Must do
Safe
The trust must ensure that specialist clinical expertise is secured to ensure expertise across the emergency department. The clinicians should provide the oversight of care provision, ensuring all patients receive care from senior clinicians that is safe, effective, timely and in line with best practice.
⚠ The trust currently has a condition on its registration for the treatment of disease, disorder and injury to ensure that specialist clinical expertise is secured to ensure expertise across the emergency department. We saw that working relationships and communication across the specialist departments had improved however, some patients still experienced …
Must-do action 13 of 54
Must do
Safe
The trust must ensure that there is enough staff within the emergency department with the right qualification, skills, training and experience to keep people safe and to provide the right care and treatment.
⚠ The trust currently has a condition on its registration for the treatment of disease, disorder and injury to ensure there are sufficient numbers of suitably qualified skilled, competent and experienced clinical staff at all times to meet the needs of patients within all areas of the Emergency Department, including any …
Must-do action 14 of 54
Must do
Safe
The trust must ensure that it follow through with plans to train all recovery staff in Advanced Life Support training in line with guidance.
⚠ Staff in the recovery area did not have the appropriate level of life support training in line with Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidance.
Must-do action 15 of 54
Must do
Safe
The provider must ensure that the premises used by the service are safe for their intended purpose, including ensuring the premises are safe for patients admitted with a mental health condition.
⚠ The service did not always have suitable premises and equipment. The service did not always ensure that the premises kept children and young people with a mental health condition safe. The service had not undertaken risk assessment in relation to providing care to children and young people with a mental …
Must-do action 16 of 54
Must do
Safe
The provider must ensure there are sufficient numbers of suitably qualified, competent, skilled and experienced nursing staff available to provide care to children and young people.
⚠ The service did not have enough nursing staff, with the right mix of qualifications and skills, to keep patients safe and provide the right care and treatment.
Must-do action 17 of 54
Must do
Safe
The provider must review the counting of trainee nurse associates within the registered staff numbers on the neonatal unit.
⚠ The service did not have enough nursing staff, with the right mix of qualifications and skills, to keep patients safe and provide the right care and treatment.
Must-do action 18 of 54
Must do
Safe
The provider must ensure there are sufficient numbers of suitably qualified, competent, skilled and experienced medical staff available to provide care to children and young people.
⚠ The service did not have enough medical staff, with the right mix of qualifications and skills, to keep patients safe and provide the right care and treatment.
Must-do action 19 of 54
Must do
Responsive
The providemust ensure that suitable transitional pathways from children’s services to adult services are in place to meet the needs and reflect the personal preferences of young people.
⚠ The service did not have a transition pathway or policy in place to support young people transitioning from children’s service to adult services. This had not improved from the last inspection of the service.
Must-do action 20 of 54
Must do
Responsive
The provider must ensure that care is planned and delivered in a way that meets the individual needs of all children, young people and those close to them, including those children and young people with a mental health condition. (Regulation 9(1)).
Regulation: Regulation 9(1)
⚠ The trust did not plan and provide services in a way that met the needs of all children, young people and families. The service did not consistently take account of the individual needs of children, young people and those close to them.
Must-do action 21 of 54
Must do
Well-led
The provider must ensure that systems are in place to make sure all complaints are investigated without delay and learning from complaints shared across the service.
⚠ The service did not investigate concerns and complaints in a timely manner or share lessons learnt with all staff.
Must-do action 22 of 54
Must do
Well-led
The provider must have systems and processes in place to monitor progress against plans, including a vision and strategy, to improve the quality and safety of services.
⚠ The service did not have a robust vision for what it wanted to achieve, and could not demonstrate workable plans to turn it into action, developed together with staff, patients and key groups representing the local community.
Must-do action 23 of 54
Must do
Well-led
The provider must ensure it has systems and processes in place to collect, analyse and use information to improve quality and safety across the service.
⚠ The service did not always collect, analyse, manage and use information well to support all its activities.
Must-do action 24 of 54
Must do
Safe
The trust must ensure staff follow infection control procedures at all times.
⚠ Staff did not always use control measures to prevent the spread of infection.
Must-do action 25 of 54
Must do
Safe
The trust must ensure local rules in ophthalmology are kept up to date and regularly reviewed.
⚠ In the ophthalmology department local rules and risk assessments were out of date and this had not been identified by leaders.
Must-do action 26 of 54
Must do
Safe
The trust must ensure clear plans are in place around deteriorating patients including the use of the sepsis screening tool.
⚠ Risks to people such as deterioration of patients and sepsis were not always adequately assessed and were not always managed safely.
Must-do action 27 of 54
Must do
Safe
The trust must ensure robust systems are in place around missing/patient notes, to include effectively monitoring the amounts and developing robust plans of action.
⚠ Records were not always available to all staff providing care. There were issues with the tracking of patient notes which were transported between the department and centre file where records were being stored. This had not yet been resolved.
Must-do action 28 of 54
Must do
Well-led
The trust must ensure all risks are reviewed on the departmental risk register and that action is taken to move risks on.
⚠ Risk registers showed limited movement.
Must-do action 29 of 54
Must do
Safe
The trust must ensure they review the suitability of premises outpatients and the ophthalmology department and review patient flow thought the departments.
⚠ The environment was not suitable for the number of patients seen. Leaders recognised the need to review patient flow through the department.
Must-do action 30 of 54
Must do
Safe
The trust must ensure clear plans are in place around deteriorating patients; to include a review of the availability of resuscitation equipment, the storage of anaphylaxis kits, cascading learning from the revised cardiac arrest procedure and assessing the risk of clinical support workers working in clinics without the direct supervision of a registered nurse.
⚠ Risks to people such as deterioration of patients and sepsis were not always adequately assessed and were not always managed safely.
Must-do action 31 of 54
Must do
Safe
The trust must ensure systems are in place to improve the accessibility of patient notes, to include effectively monitoring the volume of missing notes and developing clear plans of action to reduce the use of temporary notes.
⚠ Records were not always available to all staff providing care.
Must-do action 32 of 54
Must do
Safe
The trust must ensure Improve the storage of patient notes within the department in relation to confidentiality and information governance requirements and health and safety.
⚠ Records were not stored safely or securely within the department.
Must-do action 33 of 54
Must do
Well-led
The trust must ensure all risks are mitigated and reviewed on the departmental risk registers and that action is taken to move risks on.
⚠ Not all risks were fully recognised and mitigated.
Must-do action 34 of 54
Must do
Safe
The trust must ensure risks to patients in urology are effectively managed in relation to the use of trolleys with no sides for patients undergoing invasive procedures.
⚠ Risks to people such as deterioration of patients and sepsis were not always adequately assessed and were not always managed safely.
Must-do action 35 of 54
Must do
Safe
The trust must ensure they review the suitability of the outpatient premises in relation to patient flow thought the department.
⚠ The environment was not suitable for the number of patients seen. Leaders recognised the need to review patient flow through the department.
Must-do action 36 of 54
Must do
Safe
The trust must ensure they improve mandatory staff training compliance
⚠ The service provided mandatory training in key skills to all staff but did not make sure everyone completed it.
Must-do action 37 of 54
Must do
Safe
The trust must ensure they improve the uptake of safeguarding staff training
⚠ The service provided mandatory training in key skills to all staff but did not make sure everyone completed it.
Must-do action 38 of 54
Must do
Safe
The trust must ensure they put in place a protocol for managing a deteriorating adult or child including training staff in paediatric life support
⚠ There was no system in place to assess and monitor the condition of inpatients or emergency department patients as they attended Imaging services. There was no protocol in place to manage a deteriorating child or adult patient.
Must-do action 39 of 54
Must do
Safe
The trust must ensure they improve resuscitation adults staff training compliance
⚠ The service provided mandatory training in key skills to all staff but did not make sure everyone completed it.
Must-do action 40 of 54
Must do
Safe
The trust must ensure they put in place an effective system for measuring the safety of imaging services
⚠ The service did not use safety monitoring results. Staff did not collect safety information and share it with staff, patients and visitors. Managers could not use safety monitoring results to improve the service.
Must-do action 41 of 54
Must do
Safe
The trust must ensure they put in place a system of medical supervision of inpatients waiting on corridors for Imaging appointments.
⚠ The service did not monitor and manage the general safety of patients. Staff checked the suitability of the imaging procedures against the patient’s needs, but the wellbeing of inpatients was not monitored and managed while they attended and waited.
Must-do action 42 of 54
Must do
Caring
The trust must ensure inpatients and ED patients waiting for imaging appointment’s on corridors are kept sufficiently warm
⚠ Some institutionalised systems had a negative impact on the most vulnerable patient’s dignity and privacy.
Must-do action 43 of 54
Must do
Caring
The trust must ensure inpatients and ED patients waiting for imaging appointment’s on corridors are able to be modestly covered
⚠ Some institutionalised systems had a negative impact on the most vulnerable patient’s dignity and privacy.
Must-do action 44 of 54
Must do
Effective
The trust must ensure they put in place guidelines for pain assessment in children
⚠ Staff were not aware of trust guidelines for pain in children although the Imaging service at Russells Hall Hospital treated children. Staff were not aware of tools available to assess pain in adults who could not communicate verbally.
Must-do action 45 of 54
Must do
Responsive
The trust must ensure they take effective steps to meet the diagnostic standard and to catch up with paediatrics anesthetic, colonoscopy and cardiac waiting lists.
⚠ People could not always access the service when they needed it. Waiting times from referral to diagnostic testing were not all in line with good practice and there was no credible plan to catch up some long waiting lists.
Must-do action 46 of 54
Must do
Well-led
The trust must ensure they review and improve the Imaging services measures of quality and patient outcomes
⚠ Managers did not monitor the effectiveness of care and treatment to use the findings to improve them. They did not compare local results with those of other services to learn from them.
Must-do action 47 of 54
Must do
Well-led
The trust must ensure they put in place an effective management and governance structure in imaging services and monitor its performance
⚠ Managers at all levels in the service did not have the right skills and abilities to run Imaging services and provide high-quality sustainable care. Local leaders were not aware of all the risks and challenges in the service. Managers and clinical leads did not have oversight of the overall quality …
Must-do action 48 of 54
Must do
Safe
The trust must ensure confidential patient information is protected from casual view and hearing in imaging services.
⚠ Some institutionalised systems had a negative impact on the most vulnerable patient’s dignity and privacy.
Must-do action 49 of 54
Must do
Well-led
The trust must ensure they review and improve the diagnostic imaging services measures of quality and patient outcomes.
⚠ Outcomes for patients were not routinely measured against national standards to ensure the best possible outcomes.
Must-do action 50 of 54
Must do
Well-led
The trust must ensure they put in place an effective management and governance structure in diagnostic imaging services and monitor its performance.
⚠ The service was not managed appropriately. Leaders did not understand the challenges to quality and sustainability of the service. The leadership team lacked leadership skills and had little oversight and understanding of the significant issues in the service.
Must-do action 51 of 54
Must do
Safe
The trust must ensure they improve mandatory staff training compliance.
⚠ Staff were not up to date with mandatory training and trust targets were not met.
Must-do action 52 of 54
Must do
Safe
The trust must ensure they put in place a protocol for managing a deteriorating adult or child including training staff in paediatric life support.
⚠ Risks to patients were not routinely assessed including risks to the deteriorating patient. Medical emergencies were not responded to appropriately with staff confused about the process.
Must-do action 53 of 54
Must do
Safe
The trust must ensure they improve resuscitation for adults’ staff training compliance.
⚠ Staff were not up to date with mandatory training and trust targets were not met.
Must-do action 54 of 54
Must do
Safe
The trust must ensure they put in place an effective system for measuring the safety of diagnostic imaging services.
⚠ There were no track records on safety and no processes in place for learning from incidents when things went wrong.

Should-do actions (52)

Recommended improvements to enhance service quality.

Should-do action 1 of 52
Should do
Safe
The trust should ensure that at night, senior doctors in the emergency department have sufficient time to treat children as well as patients in the resuscitation room.
Should-do action 2 of 52
Should do
Safe
The trust should ensure that infection control policies and practice are implemented and followed throughout the emergency department.
Should-do action 3 of 52
Should do
Caring
The trust should ensure that patients’ privacy is respected in the waiting and reception areas of the emergency department.
Should-do action 4 of 52
Should do
Effective
The trust should ensure effective monitoring and audit of treatment and interventions used for mental health patients within the emergency department.
Should-do action 5 of 52
Should do
Responsive
The trust should ensure that leaflets are information are available in other languages than English within the emergency department.
Should-do action 6 of 52
Should do
Safe
The trust should ensure that paediatric staff are alerted to unwell children on their way to the department.
Should-do action 7 of 52
Should do
Safe
The trust should ensure medical are up to date with mandatory training; including mental health and safeguarding training.
Should-do action 8 of 52
Should do
Safe
The trust should ensure substance managed under Control of Substances Hazardous to Health (COSHH) regulations are stored safely.
Should-do action 9 of 52
Should do
Effective
The trust should ensure patients attending the surgical ambulatory assessment unit are triaged within trust targets; and this is formally monitored.
Should-do action 10 of 52
Should do
Safe
The trust should ensure records are updated with 24-hour venous thromboembolism (VTE) assessment outcomes.
Should-do action 11 of 52
Should do
Safe
The trust should ensure all staff have access to learning following never events and serious incidents.
Should-do action 12 of 52
Should do
Effective
The trust should ensure staff follow a standardised approach to reducing unnecessary fasting prior to surgery. Enable a way for this to be audited consistently by local managers.
Should-do action 13 of 52
Should do
Caring
The trust should ensure staff are trained in autism and where necessary access materials to support awareness and to aid individualised treatment and care.
Should-do action 14 of 52
Should do
Safe
The trust should ensure that it follow through with plans to replace all the wooden cabinets with metal cabinets which are used to store flammable liquids in line with guidance.
Should-do action 15 of 52
Should do
Effective
The trust should ensure that it carries out observational audits of the World Health Organisation (WHO) checklist.
Should-do action 16 of 52
Should do
Safe
The trust should ensure that all staff at Corbett Hospital are aware of the major incident plan and that there is a copy of the plan on the unit.
Should-do action 17 of 52
Should do
Safe
The trust should ensure all staff maintain to completed documentation around CTG monitoring, including ‘fresh eyes’ to ensure its consistent throughout the service.
Should-do action 18 of 52
Should do
Safe
The trust should ensure all records are kept up to date and completed accurately.
Should-do action 19 of 52
Should do
Safe
The trust should ensure all staff adhere to Infection Prevention and control policy.
Should-do action 20 of 52
Should do
Responsive
The service should ensure complaints are managed in line with the trusts complaints policy.
Should-do action 21 of 52
Should do
Effective
The trust should ensure the clinical audit programme for maternity services is fully embedded within the service.
Should-do action 22 of 52
Should do
Well-led
The service should ensure governance arrangements within maternity should ensure they have a full overview of the service.
Should-do action 23 of 52
Should do
Safe
The service should ensure hand hygiene audits are large enough sample to provide assurance.
Should-do action 24 of 52
Should do
Safe
The service should ensure venous thromboembolism (VTE) assessments are completed on all patients.
Should-do action 25 of 52
Should do
Safe
The service should ensure SHDU has a resuscitation trolley based on the unit.
Should-do action 26 of 52
Should do
Effective
The service should ensure it meets the Guidelines for the Provision of Intensive Care Services (GPICS) for dietician’s staff.
Should-do action 27 of 52
Should do
Effective
The service should ensure medical staff mental health law meets the trust’s target.
Should-do action 28 of 52
Should do
Effective
The service should ensure it complies NICE requirements QS158 for rehabilitation after critical care illness for adults.
Should-do action 29 of 52
Should do
Responsive
The service should ensure complaints are managed in line with the trust’s complaints policy.
Should-do action 30 of 52
Should do
Responsive
The service should ensure patients are discharged in less than eight hours.
Should-do action 31 of 52
Should do
Caring
The trust should ensure that children, young people and their families are involved in making decisions about care.
Should-do action 32 of 52
Should do
Responsive
The trust should review how it obtains feedback from children, young people and those close to them to improve and shapes services.
Should-do action 33 of 52
Should do
Effective
The trust should ensure they increase the numbers/availability of radiographers competent to interpret and clinically report on diagnostic images as recommended by the CQC July 2018 national report on reducing wait times for imaging results.
Should-do action 34 of 52
Should do
Safe
The trust should ensure they make available information to patients and visitors on safeguarding children and vulnerable adults from abuse
Should-do action 35 of 52
Should do
Caring
The trust should ensure they provide drinking water for patients with imaging services areas.
Should-do action 36 of 52
Should do
Effective
The trust should ensure they make staff aware of guidelines in place for use of pain score for patients with dementia.
Should-do action 37 of 52
Should do
Responsive
The trust should ensure they encourage use of the telephone interpreters service over the use of staff and relatives.
Should-do action 38 of 52
Should do
Safe
The trust should ensure that risk assessments are completed around only being one resuscitation trolley in the outpatients’ department and be certain all staff know who will fetch the trolley in an emergency and that scenario training is completed to include reception staff.
Should-do action 39 of 52
Should do
Safe
The trust should ensure notes are legible and do not contain loose pages.
Should-do action 40 of 52
Should do
Safe
The trust should ensure relevant staff can access all medications easily in the ophthalmology department.
Should-do action 41 of 52
Should do
Well-led
The trust should ensure learning from morbidity and mortality meetings are shared to aid learning.
Should-do action 42 of 52
Should do
Effective
The trust should ensure they consider a programme of audit around compliance in areas such as national institute for health and care excellence (NICE) guidelines and consent.
Should-do action 43 of 52
Should do
Responsive
The trust should ensure they continue to reduce outstanding follow up appointments.
Should-do action 44 of 52
Should do
Safe
The trust should ensure annual refresher training for patient group directives (PGD’s).
Should-do action 45 of 52
Should do
Responsive
The trust should ensure they consider ways of improving communication with the rapid access team.
Should-do action 46 of 52
Should do
Safe
The trust should ensure they review storage space in the department and complete risk assessments in relation to staff handling the records.
Should-do action 47 of 52
Should do
Well-led
The trust should ensure all risks are recorded on the departmental risk register.
Should-do action 48 of 52
Should do
Responsive
The trust should ensure they continue to reduce outstanding follow up appointments.
Should-do action 49 of 52
Should do
Well-led
The trust should ensure review processes for staff engagement and involvement in decisions affecting their roles.
Should-do action 50 of 52
Should do
Safe
The trust should ensure they have enough suitable qualified staff to ensure compliance with recommendations from national bodies such as The Association of Palliative Medicine for Great Britain and Ireland and the National Council for Palliative Care.
Should-do action 51 of 52
Should do
Responsive
The trust should ensure they continue its efforts to provide a seven-day service.
Should-do action 52 of 52
Should do
Safe
The trust should ensure they have enough medical staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

Location details

CQC ID: RNA04
Local authority: Dudley
Region: West Midlands

Inspection report

Type: Location
Date: 12 July 2019
Rating: Requires improvement
Actions: 54 must-do 52 should-do
AI-extracted 3 Jun 2026