Basildon and Thurrock University Hospitals Foundation Trust has failed to address concerns raised 10 months ago, according to the Care Quality Commission.
The foundation trust regulator Monitor intervened at the trust in November 2009 over quality concerns. In April 2010, the CQC also raised concerns about registering it with conditions “in four areas”.
In December, the final CQC registration condition was removed and January’s trust board meeting was informed of the “completion of the action plans developed to ensure compliance” with CQC conditions.
However, CQC inspectors visiting in December looked at 16 essential standards and found four in need of action and six where improvements were suggested. The CQC report, published last week, said the inspection found “evidence of a lack of consistent, timely nursing care planning and assessment practice”.
It noted that risk assessments for patients were not always in place and discharge documentation was lacking in some cases. That was a “significant concern”, the report said, because the issues had been raised and an improvement plan put in place following the CQC’s original April 2010 intervention.
The inspection found a lack of knowledge about dementia awareness and challenging behaviour, and problems addressing patients’ dietary needs.
The report said: “Two care records observed showed patients with significant weight loss, which was unexplained, and a further patient record showed poor nutritional intake, with no actions stated to address this.”
CQC regional director Frances Carey said: “Despite having all of its registration conditions lifted, the trust has not yet achieved full compliance across standards. We have made repeated visits to the trust and each time have had to impose at least one new compliance action.
“By law, providers of healthcare services have a legal responsibility to make sure they are meeting the essential standards of quality and safety.”
The CQC gave the trust 14 days to set out its improvement plans.
Basildon and Thurrock chief executive Alan Whittle said: “We have already provided the CQC with a plan of action to address the four areas where they have moderate concerns. Two of these are around the standard of nursing documentation and dementia care.
“These areas are recognised across the NHS as needing greater focus and improvement.”