PERFORMANCE: The Care Quality Commission has imposed an urgent legal restriction on the registration of Mid Yorkshire Hospitals NHS Trust, preventing it from using its Pinderfields Hospital day surgical unit for patient staying longer than 23 hours.

The regulator said it followed an unannounced visit on 5 September in response to concerns received that the specialist day unit was being used to provide longer term care, without the resources necessary to support this type of service.

CQC found a number of patients had stayed on the day surgery unit for over 24 hours during July and August 2012. In some cases patients had stayed on the unit for four days or longer.

There was no direct access to washing facilities on the unit and patients were washing from disposable cardboard bowls.

There was no night lighting installed on the unit. Staff explained that if patients were to be admitted through the night, which records showed was a frequent occurrence, full lighting on the ward had to be turned on disturbing other patients’ sleep.

Inspectors were concerned to find there were no inpatient catering facilities on the unit and only sandwiches, and more recently microwave meals, were available to patients.

Patients had no bedside storage available for their personal possessions. Inspectors found patients’ belongings left on the floor at the side of the bed.

Inspectors were concerned about the unsecured access to the adjacent theatre area and the potential hazard this posed for patients and visitors.

Malcolm Bower-Brown, deputy director of CQC in the North, said: “The failings we witnessed on this unit at Pinderfields Hospital were completely unacceptable. CQC took swift action following our inspection to ensure the safety and wellbeing of patients.

“We are heartened by the Trust’s rapid and positive response to our action and they are working closely in partnership with other agencies to address the issues of concern. However we will continue to monitor the position closely and, if necessary, will not hesitate to take further action to ensure patients receive the service they are entitled to expect.”

The trust said in a statement, responding to the CQC, that it had taken immediate action on 13 September when it was asked by the regulator to stop admiting patients for longer than 23 hours.
It said that only 30 patients had stayed for more than 23 hours.
The trust said it has now made significant improvements to “bring the unit to bring it up to the standard required for short stay inpatients”. That includes installation of bedside lights, improvement of the catering service, and installation of lockers. There will also be improvements to the washing facilities imminently.

Interim chief executive Stephen Eames said: “We would like to apologise to any patient whose experience on the day surgical unit may have fallen below the high standards we would expect.

“To our knowledge no patients have come to harm as a result of an inpatient stay on this unit. We do accept that the facilities and environment on this unit were not entirely suitable for inpatients and we are in the process of making significant improvements so it can be used for short stays.”

“The concerns raised by the CQC relate to the facilities and physical environment of the Unit for patients spending more than 23 hours there. They do not relate to the levels of staffing on the unit or the quality of care given by our staff which patients told the CQC was very good.

“We have not been routinely using the Day Surgical Unit for inpatient stays over 23 hours. This happens as part of an escalation policy which enables us to find extra capacity in the hospital for low risk inpatients in times of high demand.”