• Isle of Wight Trust’s rating raised to “requires improvement”
  • But trust remains in special measures after more than two years
  • Low staffing numbers and mental healthcare problems persist

England’s only integrated acute, community, mental health and ambulance trust will remain in special measures despite the Care Quality Commission noting improvements. 

Isle of Wight Trust’s overall CQC rating has been upgraded from “inadequate” to “requires improvement” after inspectors visited the trust during May and June.

The trust was placed in special measures in April 2017, after which current chief executive Maggie Oldham was appointed. In March this year, the CQC told the trust to take immediate action after warning it was not safely staffing its emergency department

After their most recent inspection, the CQC’s inspectors gave improved ratings to acute (“requires improvement”) and community services (“good”), while ratings for mental health and ambulance services remained the same (“inadequate” and “requires improvement” respectively).

They praised the trust’s end-of-life care, which has been redesigned in partnership with the island’s hospice. Patient transport services also garnered praise, thanks to staff making sure patients had food supplies at home when dropping them off and taking one patient for a drive along the seafront when the person said she hadn’t seen the sea for a long time.

However, the CQC also found 81 breaches of “legal requirements” and highlighted multiple failings. These included:

  • Patients not always being given enough food and drink to meet their needs;
  • The number of medical staff working in urgent and emergency services not meeting standards set by the Royal College of Emergency Medicine;
  • A lack of protocols and policies to support staff managing acute mental health patients; and
  • Theatre staff not all having had their competencies assessed and agency theatre staff having only partially completed their inductions.

Inspectors also found staff did not always follow the right protocol when patients’ conditions deteriorated. In one instance, a medical assessment unit patient’s National Early Warning Score recording had been “altered” and their condition was not escalated to medical staff.

The trust’s gynaecology service was criticised as well after inspectors reported some medical staff had “not engaged in the service” and “disregarded risk and safety processes”. Some staff failed to treat patients with “compassion and kindness” and incidents were not reported routinely.

Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said: “Although there has been progress in addressing some of the immediate issues, we felt it is still too early to judge their effectiveness.

“In particular, the trust needed to ensure there were sufficient and suitably qualified staff available and that systems to guard against risk were fully embedded to ensure patients were protected from avoidable harm.”

Ms Oldham welcomed the report’s findings and said the trust “recognises there is still a lot of work to do”.

Earlier this year, Ms Oldham was fined £500 after the trust failed to disclose serious incident investigations to the coroner. 

 

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