PERFORMANCE: Hillingdon Hospitals Foundation Trust has been told to improve after Care Quality Commission inspectors had concerns about risks to patient safety and a lack of compliance with infection control.

The trust received a “requires improvement” rating overall following the inspection in October. The safety of its services was found to be “inadequate”, while it received a “good” rating for how caring services were.

The CQC had inspected the trust in October 2013 and found it was not compliant with infection control procedures. When the inspectors returned a year later they found the trust was still failing to meet this standard.

Diabetes inspection

Inspectors were impressed by the specialist care provided for children with diabetes

While inspectors did not see patients come to any harm they had “numerous” concerns over equipment that “presented a risk to patient safety”.

Equipment was not regularly checked and the inspectors found out of date supplies of medical and surgical equipment.

There was a shortage of equipment on the children’s wards, for high dependency patients, as well as a shortage of routine items.

There was also a nursing shortage, with one nurse covering 20 patients on one ward. The report said: “We also found one ward being covered only by two bank/agency nurses and no permanent staff.”

There was good multidisciplinary working for critical care patients and strong examples of team working in other departments including extended clinic times in the outpatients departments and diagnostic services also run at weekends to support the clinics.

Inspectors found that staff were “kind and had a caring and compassionate manner”.

The trust struggled with finding enough capacity and had escalation wards to support the high number of admissions.

The inspectors found that despite extra beds being opened the occupancy rate remained high and patients were cared for on “outlier” wards and in non-specialist areas.

The trust was not monitoring and reporting the numbers of times patients moved wards and inspectors were told of high numbers of patients being moved in the night for “non-clinical reasons”.

The maternity unit was “challenged” despite a recent refurbishment. Women described crowding in the waiting room and a lack of privacy when being assessed. Inspectors were also told of women “labouring in the assessment area”.

The trust has a strong performance against 18 week referral to treatment targets.

The inspectors were also impressed by the specialist care provided for children with diabetes, specifically the outreach work into schools.

Chief executive Shane DeGaris said: “Our overall rating is not good enough for a well performing trust and we are determined to improve it. We aim to provide the highest standards of care to all our patients and we will use this report to help us make improvements wherever they are needed.

“The inspectors recognised and praised our staff for their commitment, compassion and desire to provide high standards of care to patients. Patient feedback to the CQC inspectors was positive about the trust’s staff and services. This is a solid foundation for us to make the improvements that need to be made.

“We have made significant progress implementing our improvement plan following the inspection and will continue to report on developments against this to the CQC and all our stakeholders and partners in the local community.”