- Isle of Wight rated “inadequate” again by Care Quality Commission
- Inspectors concerned about trust’s governance shortfalls
- Trust’s IT problems create “risk to patient care”
Serious shortfalls in governance “at all levels” and a “long-established bullying culture” continue to cause concern at a trust in special measures, a new report reveals.
Isle of Wight Trust remains rated “inadequate” after an inspection by the Care Quality Commission during January and February.
Professor Ted Baker, the CQC’s chief inspector of hospitals, said he had “significant concerns about patient safety” in areas of the trust’s care.
However, the CQC said the trust was showing “growing momentum and a desire to improve” under the leadership of Maggie Oldham, who has been chief executive at the trust for just over a year.
The CQC’s report said the trust, which was placed in special measures last April, did not have effective systems for identifying and reducing risks.
Inspectors reported areas of “silo working” and a “defensive culture” when staff were under pressure.
Workforce shortages was one of the biggest challenges for the trust, with a 15 per cent vacancy of nurses working within medicine.
Staff on one ward told inspectors some nurses and healthcare assistants were “often in tears” because of the difficulty in managing their workload with the lack of staff.
Some staff also reported a long-established bullying culture at the trust, which tended to manifest itself through staff being ignored or belittled.
However, the report added most staff “generally reported enjoying” working at the trust.
Inspectors criticised the trust’s use of five different electronic patient record systems, which were “not inter-connected”.
One of the systems, which holds child health services data, was “not fit for purpose”, the CQC said – with boxes of paper patient records from the last five years yet to be scanned onto the system.
Inspectors said in their report: “The inadequate access to information by relevant staff created a risk to patient care.
“There were significant gaps in information governance, and the systems and processes for the management and sharing of data.”
While the trust was rated “inadequate” in the well-led domain, the CQC praised Ms Oldham’s “exceptional leadership skills” and added there was “understanding of the huge challenge ahead”.
Ms Oldham said the trust was “under no illusions” about the amount of work ahead to turn around performance.
“We have always said that our improvement journey would not be an easy or a short one.
“As the CQC rightly concluded, we are in the early stages of our improvement journey and there is now potential for significant improvement at the trust.
“We must now build on these small but significant steps of progress in transforming care on the island.”
Addressing the issues with the electronic patient record systems, Frank Sims, deputy chief executive at the trust, said: ”We are the only integrated Trust in the country that provides ambulance, mental health, community and hospital care.
“We are therefore very different to other NHS organisations and we run dedicated information systems for each of these services to reflect the specific needs of the patients cared for.
“We have already integrated a large number of systems, so that we can link patient information. In addition, we have a programme in place that will see core patient systems connected by the end of 2018.
“Therefore whether you are seen by your GP, a district nurse, in our hospital or in one of our partner hospitals on the mainland, patient information will be accessible.
“We have also identified that we have further work to do around information governance and a full action plan to raise standards is being put in place.’’
- Article updated at 4.18pm on 6 June to include Mr Sims’s comments
CQC inspection report