Source · CQC inspection

St Richard's Hospital

Provider University Hospitals Sussex NHS Foundation Trust Type NHS Healthcare Organisation Region South East Last inspected 11 May 2026

Overall rating: Requires Improvement View full CQC report

Domain ratings

Five CQC key questions

Safe

Requires Improvement

Effective

Good

Caring

Outstanding

Responsive

Requires Improvement

Well-led

Requires Improvement

Current CQC assessment

Single Assessment Framework

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

Requires Improvement Assessed 11 May 2026

The service is not performing as well as it should and we have told the service how it must improve.

Date of assessment: 11 to 12 September 2025. St Richards Hospital provides a range of NHS hospital services, to people living in and around Chichester. This assessment looked at services for children and young people as part of our inspection schedule, which we rated as good. The rating of services for children and young people has been combined with the ratings of the other services from the last inspections. See our previous reports to get a full picture of all the other services at St Richards Hospital. At this assessment …

Ratings by service

Services for children & young people

Good

Jul 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 (2)

Breach Safe

At this assessment we found breaches of regulations in relation to safe care and treatment.

Regulation: Regulation 12 (Safe care and treatment) · 11 May 2026

Breach Overall

We found a breach of regulation to safe and care treatment.

· 11 May 2026

Earlier inspection findings

pre-2024 framework · 15 must-do

Must-do actions (15)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 15

Must do

Safe

The trust must ensure that medicines are used once opened in line with manufacturers guidance.

Regulation: Regulation 12

⚠ Fluids stored inside intravenous fluid warming cabinets were not labelled with date of placement or removal, meaning staff could not be assured they were used in line with guidance.

Must-do action 2 of 15

Must do

Safe

The trust must ensure that staff complete mandatory training in line with their role and that oversight of targets is effectively monitored.

Regulation: Regulation 12

⚠ Not all staff were up to date with mandatory training, particularly specialist surgery staff (87% compliant vs 90% target), and there was no clear plan to improve compliance.

Must-do action 3 of 15

Must do

Safe

The trust must ensure appropriate training, in line with guidance, is in place and completed by staff to support patients with learning disabilities, dementia and autism.

Regulation: Regulation 12

⚠ Mandatory training was not comprehensive, lacking dedicated training on recognising and responding to patients with mental health needs, dementia, learning disabilities, and autism, which is a statutory requirement.

Must-do action 4 of 15

Must do

Safe

The trust must ensure there are enough nursing staff to keep patients safe.

Regulation: Regulation 12

⚠ The service did not have enough nursing, allied health professionals, and support staff. Actual nurse staffing was consistently below planned establishment, with some wards having a ratio of 1 RN to 13 patients overnight.

Must-do action 5 of 15

Must do

Effective

The trust must ensure that all staff receive timely appraisals in line with provider policy.

Regulation: Regulation 12

⚠ Managers did not always ensure timely appraisals. Overall appraisal figures for the surgery division were 82% (below 90% target), and medical staff appraisal rates were only 67%.

Must-do action 6 of 15

Must do

Safe

The trust must ensure that controlled drug records and the oversight of these are in line with national guidance.

Regulation: Regulation 12

⚠ Controlled drug logbooks were not completed in line with guidance, with missing records of amounts given, witness signatures, and daily stock checks. The latest audit was overdue.

Must-do action 7 of 15

Must do

Safe

The trust must ensure the monitoring of anaesthetic machine checks is recorded and aligns with best practice guidance.

Regulation: Regulation 12

⚠ Anaesthetic machine safety checks were not recorded in logbooks on multiple occasions, contrary to AAGBI recommendations and MHRA guidelines for record keeping.

Must-do action 8 of 15

Must do

Safe

The trust must ensure that the systems used to monitor WHO checklist compliance, including brief and debrief, are effective in demonstrating compliance and able to show areas for improvement effectively in line with NPSA guidance.

Regulation: Regulation 12

⚠ Compliance for surgical briefs was 59% and for debriefs was 20% between May and July 2023, indicating non-compliance with the 5 steps to safer surgery guidelines.

Must-do action 9 of 15

Must do

Safe

The service must review its existing IPC audit monitoring systems to identify any shortfalls in infection prevention and control and so action can be taken to make improvements when needed.

Regulation: Regulation 12

⚠ Inconsistency in IPC audit completion and monitoring was found, with theatres recording 0% compliance and other wards having missing or inconsistently recorded data, making effective oversight unclear.

Must-do action 10 of 15

Must do

Safe

The trust must ensure equipment in ward and theatre environments is moved or stored in a suitable location and avoids emergency exits being blocked.

Regulation: Regulation 12

⚠ Equipment was stored in corridors, blocking an entrance to a theatre and making movement and cleaning difficult. Hazardous chemicals were not stored in line with COSHH guidance.

Must-do action 11 of 15

Must do

Responsive

The trust must ensure action is taken to improve their compliance with national waiting list targets and that performance data for the trust can be separated to show site performance.

Regulation: Regulation 17

⚠ The service did not meet national waiting list targets (e.g., FDT 84.8% vs 96% target, 2WW cancer 66.14% vs 93% target). The trust was unable to supply site-specific performance data.

Must-do action 12 of 15

Must do

Well-led

The trust must ensure that workforce data for the trust can be separated to show individual site performance.

Regulation: Regulation 17

⚠ The trust was unable to provide assurance on ward staffing levels and lacked site-specific workforce data, limiting its ability to identify concerns and implement improvements.

Must-do action 13 of 15

Must do

Safe

The trust must ensure that patient record documents and systems are reviewed to ensure staff have access to patient information that is accessible, accurate and up to date across all electronic or paper-based records.

Regulation: Regulation 17

⚠ Patient records were difficult to review, not consistently written, and lacked a set order. Staff experienced frustration with mixed electronic/paper systems and delays due to the admissions system not creating electronic records for some patients.

Must-do action 14 of 15

Must do

Well-led

The trust must ensure organisational wide learning is shared within the trust to reduce the risk of repeated incidents.

Regulation: Regulation 17

⚠ Organisational wide learning was not well implemented, and staff felt unaware of incident investigations or learning from other sites, increasing the risk of repeated incidents.

Must-do action 15 of 15

Must do

Effective

The trust must ensure that guidance documents have been reviewed and are up to date.

Regulation: Regulation 17

⚠ Policies, guidance, and documents were often past their review dates due to delays in the standardisation process. For example, perioperative guidance from 2018 was still in use despite being superseded in 2021.