Quality | 2009.11.26
Hygiene inquiry at Essex NHS trust
Blood-stained floors, out-of-date equipment and apparent mould in machines found at Basildon and Thurrock hospitals trust
An Essex NHS hospital trust found to have blood-splattered equipment and an unusually high death rate among patients is being investigated by health inspectors. Action is being taken against Basildon and Thurrock University Hospitals NHS foundation trust after an inspection last month revealed hygiene failures and raised concerns about excessive death rates.
The Care Quality Commission (CQC) and Monitor, the body charged with regulating semi-autonomous NHS foundation trusts, have demanded changes in practices that breached patient protection standards.
Among the failures CQC inspectors identified on 8 October were floors stained with blood, resuscitation equipment more than four years out of date and what appeared to be mould growing in pieces of medical suction machines.
It is the second time this year that a foundation trust has been found to have poor standards. More than 400 patients were said to have died needlessly over three years at Mid-Staffordshire NHS foundation trust due to healthcare failures.
The CQC report said: "In the accident and emergency department we … saw floors that were stained with blood and other fluid spillages and black dirt had accumulated in the corners of the bay areas. Six out of 12 privacy curtains we checked were soiled, some with blood spatter." Patient trolleys had side rails that were "marked and sticky".
In other areas, the inspectors noticed that "six procedure trays used by staff to carry equipment when they take blood samples or give injections had blood spatter on them, a commode was soiled under the seat, and several blood pressure cuffs were stained". In A&E they saw "a trolley mattress with a hole in the cover; we asked the nurses to check the mattress and it was found to be badly soiled and to have a foul odour. In all, 12 mattresses were checked by trust staff and 11 were stained through to the foam.
"We saw tubing that is for single use only that was still attached to a ventilator after use. We saw other single-use items that were out of date in the accident and emergency store. In the clean stores we found a blood-spattered procedure tray.We saw four blood pressure machines, all were dusty. Three blood pressure cuffs were stained, including a children\'s blood pressure cuff that was very heavily stained with blood."
The trust has two hospitals for about 310,000 people in south-west Essex. The largest, Basildon University hospital, has 777 beds; outpatient care is provided at Orsett hospital. In 2004 the trust achieved foundation status, which allows greater freedom to manage finances. Basildon and Thurrock was rated "good" on quality of service in the CQC 2008-09 assessment, "excellent" for financial management, and got 13 out of 14 for cleanliness, seven out of eight for care standards and full marks for keeping the public healthy.
The CQC issued a warning notice demanding improvements on 20 October; the deadline runs out on Monday.
Cynthia Bower, CQC chief executive, said: "Swift action is needed at Basildon to nip problems in the bud. We want to ensure the trust takes swift and positive action to prevent poor quality care. We believe that effective action will now take place as a result of this joint regulatory action."
The trust\'s chief executive, Alan Whittle, said he was confident the hospital would meet Monday\'s deadline. "We are deeply disappointed that we were found wanting in three of the 15 measures covered by this inspection," he said. "I am confident the actions we, and our cleaning contractor, are taking will return us to compliance by 30 November."
A trust spokeswoman said that on the day of the inspection, an emergency order for 30 new trolley mattresses was placed, which ensured all were changed the following day. Trolley mattresses in other departments were checked on inspection day and regular checks were added to the inspection programme, which previously only included mattresses on beds.
The Liberal Democrat health spokesman, Norman Lamb, said: "People have a right to know how on earth a hospital can be rated \'good\' a few weeks before such serious failings come to light. This government has set up a labyrinth of bodies and inspectors which are meant to ensure high quality standards in our hospitals – but it simply isn\'t working. This is yet another case where a hospital has passed the test on paper but where real patient safety has clearly been compromised."
The Conservative health spokesman, Andrew Lansley, said: "When the appalling standards of care at Stafford hospital [this year] were revealed we were assured by Labour ministers that it was \'an isolated case\'; that sort of complacency is simply not good enough. Other hospitals with high mortality rates, such as Basildon and Thurrock, should have been looked at rapidly and effectively by regulators and ministers to ensure that patients were being treated safely."
For more information, please visit
http://www.guardian.co.uk/society/2009/n[...]spitals-deaths-hygiene-inquiry
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