Source · CQC inspection

Chapel Allerton Hospital

Provider Leeds Teaching Hospitals NHS Trust Type NHS Healthcare Organisation Region Yorkshire & Humberside Last inspected 15 Feb 2019

Overall rating: Good  View full CQC report

Domain ratings

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

Earlier inspection findings

pre-2024 framework · 2 must-do 5 should-do

Must-do actions (2)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 2
Must do
Safe
The provider must ensure that staff meet the trust target for compliance with mandatory training, safeguarding and mental capacity act training.
Regulation: Regulation 18(2)
⚠ Medical staffing compliance with the mandatory training target of 80% was met for only one of the 16 modules, and was not met for any of the safeguarding modules, or the mental capacity level 2 training.
Must-do action 2 of 2
Must do
Safe
The trust must ensure that mandatory training figures including advanced resuscitation and safeguarding training meets their required levels.
Regulation: Regulation 18(2)
⚠ At Chapel Allerton Hospital the surgery service had an overall training compliance rate of 73.2% for medical staff. The 80% target was met for two out of 14 mandatory training modules for which medical staff were eligible. Less than 60% of staff had completed the two advanced resuscitation training modules …

Should-do actions (5)

Recommended improvements to enhance service quality.

Should-do action 1 of 5
Should do
Effective
The trust should continue to improve national audits in particularly the National Inpatient Falls audit.
Should-do action 2 of 5
Should do
Responsive
The trust should continue to reduce the length of stay.
Should-do action 3 of 5
Should do
Effective
The trust should continue to monitor risk of readmission rates, excess mortality outliers, and patient outcomes from national audits; and work to improve performance.
Should-do action 4 of 5
Should do
Responsive
The trust should continue to monitor the proportion of cancelled operations, 18-week referral to treatment times, and length of stays; and work to improve performance.
Should-do action 5 of 5
Should do
Responsive
The trust should display information for relatives and patients that information leaflets are available in languages other than English.

Location details

CQC ID: RR819
Local authority: Leeds
Region: Yorkshire & Humberside

Inspection report

Type: Location
Date: 15 February 2019
Rating: Good
Actions: 2 must-do 5 should-do
AI-extracted 2 Jun 2026