Source · CQC inspection

Hemel Hempstead General Hospital

Type NHS Healthcare Organisation Region East Last inspected 17 Jun 2020

Overall rating: Requires Improvement  View full CQC report

Domain ratings

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

Earlier inspection findings

pre-2024 framework · 6 must-do 34 should-do

Must-do actions (6)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 6
Must do
Safe
The trust must ensure medical staff are up to date with their mandatory training requirements.
Regulation: Regulation 18(2)(a)
⚠ Medical staff compliance for mandatory training was below the trust target.
Must-do action 2 of 6
Must do
Safe
The trust must ensure that daily safety checks of specialist equipment such as resuscitation equipment are completed.
Regulation: Regulation 12(1)(2)(e)
⚠ Staff did not always carry out daily safety checks of specialist equipment. For example, not all resus trolleys had recorded checks to ensure they were in date and ready to use in the event of an emergency. The entries on the trolley checklists were inconsistently completed.
Must-do action 3 of 6
Must do
Safe
The trust must ensure medical staff are up to date with safeguarding training.
Regulation: Regulation 13(1)(2)
⚠ Not all medical staff were up to date with safeguarding training. This was a concern we raised at our last inspection.
Must-do action 4 of 6
Must do
Safe
The trust must ensure medical staff are up to date with adult basic life support training.
Regulation: Regulation 12(1)(2)(c)
⚠ Although the service provided mandatory training in key skills to all staff, not all medical staff completed it.
Must-do action 5 of 6
Must do
Well-led
The trust must ensure that patient medical records are accurate, complete and contemporaneous including risk assessment and nutritional assessments.
Regulation: Regulation 17(2)(c)
⚠ Staff did not always keep detailed records of patients’ care and treatment. Records were not always clear or up-to-date.
Must-do action 6 of 6
Must do
Safe
The trust must ensure that risks are identified, reviewed and acted upon in a timely manner to mitigate risk.
Regulation: Regulation 12(2)(b)
⚠ Staff did not always complete or update risk assessments for each patient or take actions to remove or minimise risks.

Should-do actions (34)

Recommended improvements to enhance service quality.

Should-do action 1 of 34
Should do
Safe
The trust should ensure that all seating is fit for purpose.
Regulation: Regulation 12
Should-do action 2 of 34
Should do
Safe
The trust should ensure all cleaning materials covered by COSHH are stored in line with legislation.
Regulation: Regulation 15
Should-do action 3 of 34
Should do
Well-led
The trust should ensure that records are always clear, up-to-date or easily available to all staff providing care.
Regulation: Regulation 17
Should-do action 4 of 34
Should do
Safe
The trust should ensure that patients are weighed to facilitate medication dosing.
Regulation: Regulation 12
Should-do action 5 of 34
Should do
Safe
The trust should ensure that all medicines are stored securely in line with legislation.
Regulation: Regulation 12
Should-do action 6 of 34
Should do
Effective
The trust should ensure that pain scores are clearly recorded.
Regulation: Regulation 12
Should-do action 7 of 34
Should do
Safe
The trust should ensure that patients received antibiotics for the treatment of suspected sepsis in a timely manner.
Regulation: Regulation 12
Should-do action 8 of 34
Should do
Responsive
The trust should ensure they improve complaint response times for complex cases.
Regulation: Regulation 16
Should-do action 9 of 34
Should do
Well-led
The trust should ensure that IT systems are appropriate to service needs.
Regulation: Regulation 15
Should-do action 10 of 34
Should do
Safe
The trust should improve compliance with mandatory, mental capacity and deprivation of liberty safeguard training amongst medical staff.
Regulation: Regulation 12
Should-do action 11 of 34
Should do
Safe
The trust should ensure all medical wards are cleaned regularly and to ensure cleaning schedules are in place.
Regulation: Regulation 12
Should-do action 12 of 34
Should do
Safe
The trust should ensure all cleaning materials covered by Control of Substances Hazardous to Health Regulations 2002 (COSHH, 2002) are stored appropriately.
Regulation: Regulation 15
Should-do action 13 of 34
Should do
Safe
The trust should ensure medicines are managed in line with guidelines. The trust should ensure that antibiotic prescriptions clearly record review dates and ensure that patients weights are clearly recorded.
Regulation: Regulation 12
Should-do action 14 of 34
Should do
Caring
The trust should ensure relevant information is communicated to patients around their care and treatment.
Regulation: Regulation 9
Should-do action 15 of 34
Should do
Well-led
The trust should ensure that audit performance is in line with national targets.
Regulation: Regulation 17
Should-do action 16 of 34
Should do
Responsive
The trust should ensure they improve complaint response times for complex cases.
Regulation: Regulation 16
Should-do action 17 of 34
Should do
Well-led
The trust should ensure that IT systems are appropriate to service needs.
Regulation: Regulation 15
Should-do action 18 of 34
Should do
Safe
The trust should ensure that mandatory training compliance is above the trust target.
Regulation: Regulation 12
Should-do action 19 of 34
Should do
Safe
The trust should ensure theatre staff maintain hand hygiene at all times.
Regulation: Regulation 12
Should-do action 20 of 34
Should do
Well-led
The trust should ensure patient resuscitation and treatment plan records are completed and information is easy to locate.
Regulation: Regulation 17
Should-do action 21 of 34
Should do
Responsive
The trust should continue to ensure people can access the service when they need it.
Regulation: Regulation 17
Should-do action 22 of 34
Should do
Responsive
The trust should ensure that complaint responses are timely in line with trust policy.
Regulation: Regulation 16
Should-do action 23 of 34
Should do
Well-led
The trust should ensure that IT systems are appropriate to service needs.
Regulation: Regulation 15
Should-do action 24 of 34
Should do
Safe
The trust should ensure that mandatory training compliance is in line with trust targets.
Regulation: Regulation 12
Should-do action 25 of 34
Should do
Well-led
The trust should ensure that all staff receive annual appraisals.
Regulation: Regulation 12
Should-do action 26 of 34
Should do
Well-led
The trust should ensure that audits are used to monitor compliance with policy and performance.
Regulation: Regulation 17
Should-do action 27 of 34
Should do
Responsive
The trust should ensure that patients receive treatment within one hour of arrival to the department, in line with national guidance.
Regulation: Regulation 17
Should-do action 28 of 34
Should do
Responsive
The trust should ensure they improve complaint response times for complex cases.
Regulation: Regulation 16
Should-do action 29 of 34
Should do
Safe
The trust should ensure that National Early Warning Scores are recorded for every admission.
Regulation: Regulation 12
Should-do action 30 of 34
Should do
Safe
The trust should ensure that substances subject to the Control of Substances Hazardous to Health Regulations 2002 (COSHH, 2002), are stored safely and in line with service policy.
Regulation: Regulation 15
Should-do action 31 of 34
Should do
Safe
The trust should have systems and processes in place to ensure that staff are aware of any recent medicine related incidents and share learning from incidents.
Regulation: Regulation 12
Should-do action 32 of 34
Should do
Well-led
The trust should ensure that all incidents are reported appropriately.
Regulation: Regulation 17
Should-do action 33 of 34
Should do
Well-led
The trust should ensure that plans for the ward are shared with the team and all services are included in the hospital vision.
Regulation: Regulation 17
Should-do action 34 of 34
Should do
Responsive
The trust should ensure they improve complaint response times for complex cases.
Regulation: Regulation 16

Location details

CQC ID: RWG08
Local authority: Hertfordshire
Region: East

Inspection report

Type: Location
Date: 17 June 2020
Rating: Requires improvement
Actions: 6 must-do 34 should-do
AI-extracted 3 Jun 2026