The South Tyneside and Sunderland NHS Trust has been criticised for "failing to act" on areas of concern, not having a mental health strategy and not "consistently providing one-to-one care" for people in labour.
Inspectors from the Care Quality Commission have branded the trust - which runs services including at Sunderland Royal and South Tyneside District Hospital - as "requires improvement" and served it with legal requirements to improve across a range of areas. It has been told it must improve in 14 areas "trust-wide", a further ten relate to the medical departments at both hospitals.
These include that the NHS trust needs to improve how staff assess when a patient is deteriorating and in appropriately recording compliance with the Mental Capacity Act. There were also 11 "must-do" actions identified across the trust's maternity services.
Overall, the CQC now rates the trust as "requires improvement" for being safe, effective, responsive and well-led, but it remains "good" when it comes to being caring. In response, bosses at the trust have said they are "accelerating improvements already underway", though chief executive Ken Bremner said there were "no excuses".
The trust also pointed to patient feedback summarised in the report which noted that patients had told inspectors that staff treated them well, and that women and family using maternity services had also reported positive experiences. Hospital leaders also confirmed they have been working with NHS England's national maternity improvement programme, and are also developing a new mental health and learning disabilities strategy.
The trust has also commissioned an independent review of its governance.
The CQC report runs through a range of issues - including that when patient safety concerns were identified at both South Tyneside and Sunderland hospitals in June last year, they had not been addressed by the time of the second inspection in August.
Sarah Dronsfield, deputy director of operations for the CQC in the North, added: "During this visit, we found the trust had made some improvements but had not addressed all of the areas of concern, which resulted in continued breaches of several regulations. We also identified further breaches of regulation during our review of how well-led the trust is.
"The leadership team have taken our concerns seriously and have shared their improvement plan with us and have provided regular updates on their progress. We will continue to monitor the trust to ensure it’s putting the improvements that are needed in place and will return to check on progress."
Other issues identified included:
- Systems for managing risk "were not always effective" and that senior leaders were not able to "consistently identify, understand and manage" issues faced
- In maternity services there were "significant environmental risks and risk to infection prevention and control" which management had not picked up on - and that there was not always able to "provide one to one care for people in active labour"
- Medical staff "did not always identify and escalate deteriorating people" for review - and people with suspected sepsis "did not always receive timely assessment and treatment"
The inspection team also raised concerns based on the 2021 NHS staff survey which were "consistently below the national average". The CQC report goes on to say: "The trust results in relation to staff feeling valued, respected, and rewarded were also below the national average in every question except for satisfaction with levels of pay."
However, positives in the report included praise for senior leaders who inspectors felt had "the necessary knowledge, skills and abilities" and were "visible and approachable". Positives around the trust's "vision" and stakeholder communication were also highlighted, as was its "commitment to digital innovation".
Chief executive Ken Bremner said: "There is no doubt that the past two years has been incredibly tough but there can be no excuses. Our vision is for ‘excellence in all that we do’ and this shows we still have work to do. The CQC has shone a very welcome and helpful light on areas where we need to improve and this has come at an apt time as we look forward to the future.
"Despite all the challenges we face, people will always be treated with empathy and the utmost care and kindness here at [South Tyneside and Sunderland]. I want to thank our amazing staff for that. Given the pressure they continue to work under, it is testament to them that this care and compassion still shines through every day."
Allison Thompson, who has chaired the trust board since April last year, added the rating was "certainly not in line with our aspirations" and said: "I know this will feel disappointing for our staff. They have shown great resilience and fortitude over the past two years and continue to show such kindness, care and compassion every day as they manage the most intense and sustained levels of pressure."
Ms Thompson added the trust would "absolutely learn the lessons" from the report and was "more determined than ever to make progress".
The full CQC report, published on February 3, will be available online.
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