Source · CQC inspection

Huddersfield Royal Infirmary

Provider Calderdale and Huddersfield NHS Foundation Trust Type NHS Healthcare Organisation Region Yorkshire & Humberside Last inspected 1 Jun 2026

Overall rating: Good  View full CQC report

Domain ratings

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

Current CQC assessment

Single Assessment Framework

From 2024 CQC rates services through ongoing assessments rather than comprehensive inspections.

Good Assessed 1 June 2026
The service is performing well and meeting our expectations.
We carried out an unannounced inspection of urgent and emergency care (UEC) at Huddersfield Royal Infirmary on 13, 14 and 15 January 2026. Huddersfield Royal Infirmary is part of Calderdale and Huddersfield NHS Foundation Trust. Huddersfield Royal Infirmary provides a range of services including Urgent and Emergency Care, Medical care and Outpatients. This inspection looked at UEC services in response to concerns raised to us around safe care and treatment and in preparation for a trust level well led inspection. The inspection focused on quality statements under the Safe, Effective, …

Ratings by service

Urgent and emergency services
Requires Improvement
Oct 2025

Regulatory breaches & enforcement

Current-framework "must do" equivalent

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, stated verbatim in the CQC assessment.

Breaches identified (3)

Breach Caring
We found breaches of regulations in relation to safe care and treatment, dignity and respect and staffing.
Regulation: Regulation 10 (Dignity and respect) · 1 Jun 2026
Breach Overall
We also identified new breaches of regulation.
· 1 Jun 2026
Breach Overall
We found a continued breach of regulation in relation to the management of patients presenting with mental ill health.
· 1 Jun 2026

Earlier inspection findings

pre-2024 framework · 29 must-do 51 should-do

Must-do actions (29)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 29
Must do
Well-led
The trust must improve its financial performance to ensure services are sustainable in the future.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ The current financial position posed a significant risk to the long term sustainability of the trust.
Must-do action 2 of 29
Must do
Safe
The trust must ensure they have robust systems for checking equipment and consumables and identifying and disposing of expired items.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ We found out of date consumables in the resuscitation area in drawers and grab bags; Consumables in some areas of the department did not appear to be checked regularly and were expired.
Must-do action 3 of 29
Must do
Safe
The trust must ensure that systems and processes are in place and followed for the safe storage, security, recording and administration of medicines including controlled drugs.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ We found expired medication, out of range fridge temperatures that had not been escalated and gaps in recording medication in the controlled drugs register; The service was not recording or storing medicines appropriately.
Must-do action 4 of 29
Must do
Safe
The trust must ensure that they meet environmental audit targets for cleanliness or infection control.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ The service did not always meet environmental audit targets for cleanliness or infection control; We found some areas on inspection that required deep cleaning; Recent environmental audits showed that the department did not always meet targets set for 11 out of 12 key areas.
Must-do action 5 of 29
Must do
Safe
The trust must ensure that deviations to appropriate fridge temperatures are escalated in line with internal policies.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Out of range fridge temperatures that had not been escalated.
Must-do action 6 of 29
Must do
Safe
The trust must ensure there is a suitable ligature room to accommodate patients presenting with mental ill-health.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ There was not a suitable room to accommodate patients presenting with mental ill-health.
Must-do action 7 of 29
Must do
Safe
The provider must remove ligature risks identified in key areas of the department.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ There were ligature risks in the toilets and the room currently used to accommodate patients.
Must-do action 8 of 29
Must do
Safe
The trust must ensure that systems and processes are in place and followed for the safe storage, security, recording and administration of medicines including controlled drugs.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ At the time of our inspection the service was not recording or storing medicines appropriately. We found out of range fridge temperatures and gaps in recording of controlled drugs.
Must-do action 9 of 29
Must do
Safe
The trust must ensure that deviations to appropriate fridge temperatures are escalated in line with internal policies.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Out of range fridge temperatures that had not been escalated.
Must-do action 10 of 29
Must do
Safe
The trust must ensure there is a suitable ligature room to accommodate patients presenting with mental ill-health.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ There was no suitable room to accommodate patients presenting with mental ill-health.
Must-do action 11 of 29
Must do
Safe
The trust must remove ligature risks identified in key areas of the department.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ We found ligature risks in the toilets and the small waiting room in the majors area, as well as the cubicle used to accommodate patients presenting with mental ill-health.
Must-do action 12 of 29
Must do
Safe
The trust must ensure that they meet environmental audit targets for cleanliness or infection control.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ The service did not always meet environmental audit targets for cleanliness or infection control. We found some areas on inspection that required deep cleaning.
Must-do action 13 of 29
Must do
Safe
The trust must ensure they have robust systems for checking equipment and consumables and identifying and disposing of expired items.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Consumables in some areas of the department did not appear to be checked regularly and were expired.
Must-do action 14 of 29
Must do
Safe
The trust must ensure medical staffing at Calderdale is in line with Guidelines for the Provision of Intensive Care Services 2015 (GPICS) standards.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Guidelines for the Provision of Intensive Care Services 2015 (GPICS) standards were not met as consultants had other areas of responsibility when on call and the rota did not provide continuity of care for patients.
Must-do action 15 of 29
Must do
Safe
The trust must ensure paper prescription charts are fully completed ensuring second signatures and batch numbers are recorded.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ We found an number of omissions in the paper element of the prescription charts we reviewed such as an absence of second signatures and batch numbers of drugs.
Must-do action 16 of 29
Must do
Safe
The trust must ensure all incidents are identified, reported and investigated, in a timely way.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Staff did not always recognise, report or record incidents and not all incidents were effectively investigated.
Must-do action 17 of 29
Must do
Well-led
The trust must ensure that learning from incidents is shared, implemented, monitored and tested to embed lessons learned.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ We were not assured that governance systems were effective in escalating potential risks and issues, or that learning from incidents was embedded; Opportunities for learning from incidents were missed.
Must-do action 18 of 29
Must do
Safe
The trust must ensure at all times there are sufficient numbers of suitably skilled, qualified and experienced staff to reflect patients’ clinical needs.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Staffing did not always meet defined minimum staffing levels.
Must-do action 19 of 29
Must do
Safe
The trust must ensure at all times there is sufficient staffing skills mix in line with best practice and national guidance to ensure clinical oversight and respond to patients’ clinical needs.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ The staffing skill mix did not always ensure staff had sufficient skills and experience to respond to patients’ risks and nursing needs; There was not always sufficient clinical oversight of patients and the risk of patient deterioration was not always recognised.
Must-do action 20 of 29
Must do
Effective
The trust must ensure staff complete induction training to enable them to carry out the duties they are employed to perform.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Not all staff had completed induction training and staff told us the induction process for new staff or bank and agency workers was not robust.
Must-do action 21 of 29
Must do
Safe
The trust must ensure staff complete mandatory training to enable them to carry out the duties they are employed to perform, including training in life support and in assessing and responding to patient’s risks.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Not all staff had the skills they needed to carry out their role effectively and in line with best practice. The overall mandatory training compliance rate (75%) was below the trust target of 95%. Only 40% of staff had completed basic life support (resuscitation) within the last 12 months.
Must-do action 22 of 29
Must do
Effective
The trust must ensure staff have the necessary competencies to enable them to carry out the duties they are employed to perform.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ We found that not all staff had completed role-specific competencies as required. Some staff were working as shift leaders before their relevant competencies had been signed off.
Must-do action 23 of 29
Must do
Safe
The trust must ensure patient record systems are in place to ensure staff have access to the information they need to respond to risks to patients and provide high quality care.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Patient information was not always consistently recorded and staff did not always have access to the information they needed to keep patients safe. There were inconsistencies between information recorded in electronic and paper systems.
Must-do action 24 of 29
Must do
Safe
The trust must ensure risks to patients are assessed, monitored and mitigated.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Patients’ clinical risks were not consistently assessed, monitored or recorded to ensure they were safe and received appropriate intervention and support. This included risk of falls, pressure damage, infection and risks relating to nutrition and hydration.
Must-do action 25 of 29
Must do
Effective
The trust must ensure the nutrition and hydration needs of patients are met.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Patients’ nutrition and hydration needs were not consistently met or monitored to ensure they were kept safe and potential deterioration could be readily identified.
Must-do action 26 of 29
Must do
Responsive
The trust must ensure care is sufficiently personalised to take account of individual needs.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Care planning was not sufficiently personalised to meet individual needs, for example in relation to disability or language. Systems to meet patients’ individual needs, were not embedded.
Must-do action 27 of 29
Must do
Well-led
The trust must ensure leadership and management processes are clear and roles and escalation processes are effective.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ The leadership model was confusing, roles and responsibilities were not clear and there was insufficient clinical oversight of patients.
Must-do action 28 of 29
Must do
Well-led
The trust must ensure governance systems and processes enable oversight of operational risks and challenges.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ We were not assured that governance systems were effective in identifying and escalating potential risks and issues, or that learning from incidents was embedded; The issues we raised had not been identified within the provider’s own monitoring or audits systems.
Must-do action 29 of 29
Must do
Well-led
The trust must ensure systems are in place to measure the effectiveness and responsiveness of the service, and that relevant data is used to inform service-planning and evaluation.
Regulation: Regulation 17 HSCA (RA) Regulations 2014 Good governance
⚠ There was limited relevant data to enable the service to evaluate its performance. Available data was not routinely used to inform ongoing service planning or evaluation; The management of performance was not robust. There was a lack of meaningful data which meant the service was unable to properly evaluate the …

Should-do actions (51)

Recommended improvements to enhance service quality.

Should-do action 1 of 51
Should do
Well-led
The trust should improve engagement and involvement with all staff groups with protected characteristics, such as staff with a disability or LGBT staff.
Should-do action 2 of 51
Should do
Well-led
The trust should improve the effectiveness of the Freedom to Speak up process.
Should-do action 3 of 51
Should do
Effective
The trust should develop processes to measure the outcomes of mental health patients in order to identify opportunities to improve care.
Should-do action 4 of 51
Should do
Well-led
The trust should strengthen on-going assurance and management oversight processes across the trust.
Should-do action 5 of 51
Should do
Safe
The trust should improve medicines management processes including monitoring of staff compliance and availability of pharmacy team support and oversight.
Should-do action 6 of 51
Should do
Effective
The trust should continue to strengthen staff knowledge and training in relation to mental capacity act and deprivation of liberty safeguards.
Should-do action 7 of 51
Should do
Responsive
The trust should ensure there are leaflets and resources available to patients whose first language is not English.
Should-do action 8 of 51
Should do
Safe
The trust should ensure that all staff complete mandatory training to meet their own targets for completion.
Should-do action 9 of 51
Should do
Safe
The trust should ensure they work to meet the Royal College of Emergency Medicine recommendation of 16 hours consultant presence in the department.
Should-do action 10 of 51
Should do
Safe
The trust should ensure that children are seen in an appropriate environment by staff that are suitably skilled, qualified and experienced.
Should-do action 11 of 51
Should do
Safe
The trust should ensure that all staff complete mandatory training to meet their own targets for completion.
Should-do action 12 of 51
Should do
Safe
The trust should ensure they work to meet the Royal College of Emergency Medicine recommendation of 16 hours consultant presence in the department.
Should-do action 13 of 51
Should do
Effective
The trust should continue to strengthen staff knowledge and training in relation to mental capacity act and deprivation of liberty safeguards.
Should-do action 14 of 51
Should do
Responsive
The trust should ensure there are leaflets and resources available to patients whose first language is not English.
Should-do action 15 of 51
Should do
Safe
The trust should ensure paper prescription charts are fully completed ensuring second signatures and batch numbers are recorded.
Should-do action 16 of 51
Should do
Safe
The trust should continue to work with staff to ensure sepsis screening is clearly recorded within the correct part of the electronic patient record.
Should-do action 17 of 51
Should do
Safe
The trust should encourage incident reporting within the unit to ensure all incidents including near misses are reported.
Should-do action 18 of 51
Should do
Safe
The trust should ensure staff are aware of safety performance within the unit and up to date information is displayed.
Should-do action 19 of 51
Should do
Effective
The trust should ensure data is collected for National Outreach Forum (NOF) and the achievement of West Yorkshire Critical Care Operational Delivery Network (WYCCODN) competencies and standards within the critical care outreach team.
Should-do action 20 of 51
Should do
Caring
The trust should use patient diaries in line with the guidelines for the provision of intensive care services (GPICS) recommendations.
Should-do action 21 of 51
Should do
Safe
The trust should ensure the system for checking emergency equipment and transfer equipment in the intensive care unit at Calderdale is clear, and should consider signing and dating the seal on the resuscitation trolley to provide assurance that the contents have not been tampered with between checks.
Should-do action 22 of 51
Should do
Safe
The trust should continue to work with staff to ensure sepsis screening is clearly recorded within the correct part of the electronic patient record.
Should-do action 23 of 51
Should do
Safe
The trust should encourage incident reporting within the unit to ensure all incidents including near misses are reported.
Should-do action 24 of 51
Should do
Safe
The trust should ensure staff are aware of safety performance within the unit and up to date information is displayed.
Should-do action 25 of 51
Should do
Effective
The trust should ensure data is collected for National Outreach Forum (NOF) and the achievement of West Yorkshire Critical Care Operational Delivery Network (WYCCODN) competencies and standards within the critical care outreach team.
Should-do action 26 of 51
Should do
Caring
The trust should use patient diaries in line with GPICS recommendations.
Should-do action 27 of 51
Should do
Safe
The trust should ensure all staff are up to date with mandatory training.
Should-do action 28 of 51
Should do
Responsive
The trust should respond to complaints in a timely manner and in line with their policy.
Should-do action 29 of 51
Should do
Safe
The trust should ensure that there is adequate staffing and accessible on-call cover at Huddersfield Birth Centre.
Should-do action 30 of 51
Should do
Safe
The trust should upgrade the attendance times of ambulances for priority one cases at Huddersfield birth centre from presenting a low risk to presenting a moderate risk on the maternity risk register.
Should-do action 31 of 51
Should do
Safe
The trust should continue to monitor transfer rates from Huddersfield Birth centre to the Calderdale site, and review why rates appear high compared to national averages.
Should-do action 32 of 51
Should do
Responsive
The trust should consider the necessity of closures of Huddersfield birth centre and their effect on the viability of the centre.
Should-do action 33 of 51
Should do
Safe
The trust should ensure all staff are up to date with mandatory training.
Should-do action 34 of 51
Should do
Responsive
The trust should respond to complaints in a timely manner and in line with their policy.
Should-do action 35 of 51
Should do
Safe
The trust should ensure all staff are up to date with safeguarding training; including safeguarding adults training.
Should-do action 36 of 51
Should do
Safe
The trust should consider the security arrangements in maternity areas to include the continued plans for electronic tags for babies. Additional guidance should be included in the abduction policy as regards vulnerable infants.
Should-do action 37 of 51
Should do
Safe
The trust should ensure that best practice staffing guidance as identified by the Royal College of Nursing (2013) is fully implemented.
Should-do action 38 of 51
Should do
Effective
The trust should ensure that the ‘Facing the Future’ standards are fully achieved.
Should-do action 39 of 51
Should do
Effective
The trust should ensure that children and young people’s mental health training sessions are available for staff.
Should-do action 40 of 51
Should do
Safe
The trust should ensure that arrangements are in place to monitor when band five staff are in charge of ward 18 without the advanced paediatric nurse practitioner (APNP) being present being present.
Should-do action 41 of 51
Should do
Safe
The trust should ensure that best practice staffing guidance as identified by the Royal College of Nursing (2013) is fully implemented.
Should-do action 42 of 51
Should do
Effective
The trust should ensure that the ‘Facing the Future’ standards are fully achieved.
Should-do action 43 of 51
Should do
Effective
The trust should ensure that children and young people’s mental health training sessions are available for staff.
Should-do action 44 of 51
Should do
Safe
The trust should ensure that all medical equipment in the neonatal unit is serviced as per contract identified.
Should-do action 45 of 51
Should do
Safe
The trust should ensure that the records trolley on the neonatal unit is locked.
Should-do action 46 of 51
Should do
Safe
The trust should ensure that all staff in the children’s outpatient department are aware of where to access a resuscitation trolley.
Should-do action 47 of 51
Should do
Effective
The trust should ensure patients’ capacity is considered in care planning.
Should-do action 48 of 51
Should do
Well-led
The trust should improve local audit systems, including documentation and environmental audits.
Should-do action 49 of 51
Should do
Effective
The trust should ensure patient outcomes are measured and monitored.
Should-do action 50 of 51
Should do
Responsive
The trust should ensure systems are in place to meet patients’ language support needs
Should-do action 51 of 51
Should do
Safe
The trust should ensure appropriate equipment is available to support staff in keeping patients safe, such as manual handling and falls prevention equipment.

Location details

CQC ID: RWY01
Local authority: Kirklees
Region: Yorkshire & Humberside

Inspection report

Type: Location
Date: 20 June 2018
Rating: Good
Actions: 29 must-do 51 should-do
AI-extracted 2 Jun 2026