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England's Chief Inspector of Hospitals has published his first report on the services provided by Homerton University Hospital NHS Foundation Trust at Homerton University Hospital, in Hackney, east London 

CQC rated the hospital as Good with an Outstanding Accident and Emergency (A&E) department. Staff told inspectors that they felt valued and enjoyed working in the hospital, and patients told inspectors that they felt cared for and had faith in the staff looking after them. 

Inspectors found that the A&E – the first to be rated as Outstanding by CQC under its new ratings system – was safe, effective, caring, responsive to people’s needs and well led. The department had consistently met the government’s 95% target for admitting, transferring or discharging patients within four hours since April 2013, and initiatives were in place to ensure patients were seen in a timely way.

Inspectors observed staff taking the time to listen to patients and explain to them what was wrong and any treatment needed. Patients told inspectors they had all their questions answered and felt involved in making decisions about their care. Staff told inspectors they were proud to work in the department.

The hospital had initiatives in place to reduce the number of people attending A&E. The role of a non-clinical ‘navigator’ had been introduced to support patients attending the Primary Urgent Care Centre to locate and register with their local GP so they could have their primary medical needs met in the community. There was also a team that identified the support needs of people who attended A&E on a regular basis, so these could also be met in the community.

All other services inspected across the hospital were rated as Good, and inspectors found a number of other areas of good practice, including:

• The elderly care unit had dementia care assistants to support patients.
• The palliative care nursing team and the bereavement team provided a supportive service that was that was well known to medical, nursing and therapy staff. Staff working on the medical wards told inspectors how their own knowledge and practice had been improved by the confidence and competence of individuals within these teams.
• The pharmacy department was involved in joint working with London Ambulance Service and the Hackney Clinical Commissioning Groups to introduce ‘green bags’ so that patients’ own drugs could be brought into hospital safely and transferred safely.
• Access to maternity services was also provided through a maternity telephone helpline that was available from 10am till 6pm, seven days a week. This was staffed by experienced midwives who had specific training about domestic violence, confidentiality, and handling difficult and emotional calls.
• The outpatients’ service used technology to ensure patients’ relatives and carers could be involved in their care. A clinic appointment had been organised so that a close relative could join the consultation from another country via Skype.

CQC has also told the trust that it must make improvements in a number of areas including:

• Ensuring that at all times there are enough suitably qualified, skilled and experienced staff employed on the medical wards.
• Ensuring that patient records are always accurate and include appropriate information and documents in relation to the care and treatment planned and provided.
• Ensuring that patients and/or their relatives are involved in ‘do not attempt cardiopulmonary resuscitation’ decisions and that these decisions are adequately documented.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“We identified a great deal of good practice at Homerton University Hospital – most notably in the A&E, the first to be rated as Outstanding after one of our new style inspections. I am sure that other hospitals might benefit by looking at what this trust is doing to try to reduce A&E attendances when people would be better off receiving treatment or care within the community.

“We’ve rated Homerton University Hospital as Good overall. Staff told us that that they felt valued and enjoyed their work, and patients told inspectors that they felt cared for and had faith in staff.

“Despite our findings being generally positive, there were some areas in which we’ve told the trust it must make some changes – most notably in ensuring there are always enough staff on duty on the medical wards. The trust has told us they will take action – and we’ll return in due course to check that these changes have been made.”

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts carried out an announced inspection visit in February. They examined the care provided in A&E, medical care (including older people’s care), surgery, intensive/critical care, maternity, children’s care, end of life care and outpatients. 

Inspectors also visited the hospital unannounced as part of the inspection, held focus groups with staff, and held a public listening event. The report which CQC publishes today is based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

CQC inspectors will return to Homerton University Hospital in due course as part of its regulatory programme.

Ends

For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07917 232 143. For general enquiries, call 03000 61 61 61.

Notes to editors

The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. By the end of 2015, CQC will have inspected all acute NHS Trusts in the country with its new inspection model. Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.