Royal Preston Hospital

⚠ Mandatory training for medical staff needed improvement.

⚠ Compliance for some areas of mandatory training was low for medical staff; Medical staff received but did not always keep up-to-date with their mandatory training. Compliance for completed BLS training by medical staff was 66%.

⚠ Staff did not always assess risks to patients, act on them or keep care records updated... mental health risk assessments were not always completed and actions to reduce risks for patients with mental health needs were not always taken; We also saw in three patient records we reviewed that mental …

⚠ Staff did not always complete patient records accurately or kept them up to date; in records we reviewed during inspection we saw there was inconsistent documentation of pain assessments and there was incomplete documentation in three of four records fluid balance charts we checked.

⚠ we observed a whiteboard in the emergency department displaying patient names and details of their diagnosis, which could be viewed by other patients and the public.

⚠ Staff provided antimicrobials within 1 hour of a suspected sepsis diagnosis to 78% of patients and 82% of patients within 90 minutes. New national guidance... now shows that 58% of patients received antimicrobials within an hour.

⚠ Nursing and medical staff did not always keep up with the resuscitation training. Medical staff on the division had a compliance rate of 78% for level 2 adult basic life support and paediatric basic life support whilst nursing staff had a 65% compliance rate for intermediate life support training... not …

⚠ Patient records were not always stored securely, we saw 2 patient records outside side rooms on ward 20 and a letter containing confidential details regarding a patient at an unmanned reception desk on ward 23.

⚠ The leaders for the medical division told us one of their biggest risks was the shortage of medical staff on the division. They told us there were gaps in medical cover for the respiratory service and an insufficient amount of consultant cardiologists and registrars to meet the demands of the …

⚠ People could not always access the service when they needed it and waiting times for treatment were above the England average.

⚠ Patients were not always reviewed by senior decision makers in a timely manner. We saw evidence from the Same Day Emergency Care (SDEC) Unit which showed between December 2022 and February 2023 that an average of 42% of patients had been reviewed every 24 hours by a senior decision maker …

⚠ Staff training compliance for life support, compliance with life support training was below trust targets and medical staff was below the trust target for all training other than Cardiotocography (CTG) training.

⚠ not all staff, particularly medical staff had completed all mandatory training requirements.

⚠ there were consumables, in the resuscitation area that were passed their expiry dates and the airway drawer in the emergency trollies were overcrowded.

⚠ Noticeboards, that were visible to public visitors included patient identifiable information.

⚠ The cubicle identified as the room to support patients with a mental health concern included equipment that could be used to cause self-harm.

⚠ Not all staff had training in life support, compliance with life support training was below trust targets.

⚠ Staff did not always ensure all equipment was available, in date and safe for use; we found some out-of-date items including pool evacuation nets and fire extinguishers beyond their service date.