WORKFORCE: United Lincolnshire Hospitals Trust has been heavily criticised by the Care Quality Commission over concerns about low staffing, patient safety, record keeping and management.

The trust, one of 14 inspected as part of the recent Keogh Review, failed to meet seven essential standards at its Lincoln County and Pilgrim Hospitals, the regulator found.

Inspectors, who visited the trust on five occasions during June and July, witnessed call bells being ignored by staff walking past “without checking whether the call was urgent or not.”

On one ward inspectors found the drug trolley had been left open and unattended among a high number of confused patients.

The report said: “We found all staff spoken with agreed there were staff shortages. Staff reported low staffing levels meant they could not care for their patients as they would wish to do.”

It continued: “We found a number of nurses became very emotional when discussing the stress of working short staffed. Many reported they were working longer hours, often missing breaks, going off duty late and undertaking overtime by doing extra shifts.

“We spoke with one nurse at 2.30pm; the nurse had been working since 7am and had not had a break, including a drink since starting duty.”

Inspectors were told that “because staff were rushing all the time sometimes patients were left longer on commodes”. Some patients received medications late, hourly observations of patients’ conditions were not always completed, and nurses “felt it was impossible to always keep up with paperwork and support the needs of the patients”.

The report described a “confusing picture” on decisions not to attempt resuscitation, with poor documentation and one example of a patient being subject to a DNAR without their knowledge. It also highlighted handover problems, with nurses and doctors failing to communicate. In one case, a patient with diabetic ketoacidosis was not examined by a doctor until the morning after their admission.

The regulator said there had been some improvements in staffing levels at the trust, but recruitment remained a challenge.

The board of the trust has agreed a £7 million investment in additional nursing over two years and has closed 26 beds.

The CQC report said: “In the past three years, the Care Quality Commission has continued to raise its concerns about the quality of care provided by this trust. Improvements have not been sustained.

“In response to the findings in this report, we will also require the trust to show us how it will become safe, effective, caring, responsive and well lead.”

The Trust’s Chief Executive Jane Lewington said: “It is our top priority to ensure that we provide patients with the best possible care. We are improving, but we know we have more to do.”