The Royal Oldham Urgent and Emergency Care Services CQC inspection

Libby McManus Chief Nursing Officer NCA
The Royal Oldham Urgent and Emergency Care Services CQC inspection
10 February 2021

On Monday 30th November 2020, the Care Quality Commission (CQC) conducted an unannounced inspection of the Emergency Department and urgent and emergency care services at The Royal Oldham Hospital.

A team of five inspectors arrived on site and focused on Safe, Responsive and Well Led domains.

Overall, the CQC found that the Urgent and Emergency Care Service (UECS) at Oldham was ‘well led’ and scored highly in this area, rated overall as ‘Good.’  However, in the CQC’s ‘safe and responsive’ category the service rating has been changed from ‘Good’ to ‘Requires Improvement.’

This change in CQC rating for the Urgent and Emergency Care service does not affect the overall rating of the hospital or the Pennine Acute Trust’s overall rating of ‘Good’ published in February 2020 (here) following the significant improvements that have been made over the last 5 years under leadership of Salford Royal, as part of the Northern Care Alliance Group (NCA).

Within days of the inspection, the leadership team at our Oldham Care Organisation took immediate action to rectify some of the issues highlighted, where this could be done at speed.

Libby McManus, Group Chief Nursing Officer & Director of Infection Prevention and Control for the Northern Care Alliance NHS Group, which runs The Royal Oldham Hospital (pictured), said:

“On the day the CQC inspected our Emergency Department in November last year, the inspection team saw some infection control practice which is neither acceptable nor our usual high standard and for this we are sorry to our patients and public. 

“We pride ourselves on the care we provide and take the safety of our patients and staff extremely seriously. We did not wait for this report to be published. I want to reassure those who depend on our services that immediate and decisive action was taken to address the areas of improvement required. We continue to monitor and manage the small yet significant detail of all our practice.

“Our teams have used this report to make the necessary improvements and share learning across our organisation. We are committed to listening to our patients and staff when it comes to continuing to improve the safety and quality of care in our hospitals. I am encouraged that the CQC found that our staff felt respected, supported and valued and had an open culture where they felt they could raise any concerns. We continue to do everything we can to support our people.

“The CQC’s inspection has highlighted the significant challenges and demands our staff and staff right across the NHS are under in dealing with not only high attendances, but also the impact the pandemic is having on our staff and services. We remain focused on protecting and separating Covid patients, avoiding overcrowding in A&E, and dealing with the challenge in the reduction in bed capacity due to the need for additional Covid-19 beds.

“Our work with our local health and care partners in primary care and in social care continues to focus on improving how patients flow in and out of our hospital. We must support people in the community to avoid being admitted to hospital wherever possible.

“People should continue to feel safe and confident in accessing care and treatment at our hospital services.”   

Improvements made

Since the inspection, areas where The Royal Oldham Hospital have made necessary improvements include, but are not limited to:

  • improved social distancing for staff and patients in all areas, and new estates signage
  • an acceptable distance between workstations, improved management practices, and improved monitoring of performance within the department.
  • a trial with collapsible screens has been carried out and is completed. The plan is to install these along the corridor to provide additional privacy/dignity and improve infection prevention for patients being nursed in the corridor before being moved in to a cubicle
  • our Reality Rounding Tool has been amended to reflect observation of patient care on the corridor. Regular audits are also being undertaken led by the Lead Nurse and supported by the Senior Divisional Nursing Team.
  • PPE usage and adherence to our Infection Prevention & Control (IPC) protocols is a standing item at twice daily safety huddles and in all team meetings. It also forms a key part of the induction checklist for nursing, medical staff or any new starter within the department. 

Deborah Turner, Clinical Quality Director at NHS England/ NHS Improvement - North West, said.

“Since the CQC Inspection on the 30th November 2020, NHS England/ NHS Improvement have been working closely with The Royal Oldham Hospital as they continue to strengthen their Infection Prevention and Control procedures. This has included providing support around signage, PPE compliance, and the ability of staff and patients to maintain social distancing. Of note is the work undertaken by the trust to change clinical pathways to comply with emergency screening protocols, supported by the use of lateral flow testing.”

NHS Oldham CCG Chief Operating Officer Mike Barker said:

“COVID-19 has brought many challenges for hospitals up and down the country. The team at the Royal Oldham Hospital is working extremely hard to bring about changes to improve services. Managing infection and prevention has never been more important or more difficult. We as commissioners are assured the team at the hospital are totally focused on making the necessary improvements”.

The Northern Care Alliance NHS Group (NCA) brings together Salford Royal and Pennine Acute Hospital NHS Trusts, employing over 20,000 staff, and runs four hospitals and community healthcare services in Salford, Oldham, Bury and Rochdale.

Full details of the CQC inspection and report is available on the CQC website at: https://www.cqc.org.uk/location/RW603