THE new Chief Inspector of Hospitals pinpointed Royal Bournemouth as one of the first hospitals to be assessed under the new inspection regime in the wake of the Mid Staffs scandal.

When he did so, Professor Sir Mike Richards, was acknowledging that concerns already existed about standards and performance at RBH.

The hospital has been found wanting, though the criticism in the Care Quality Commission’s 80 page report published today is more severe than many had expected.

View the Care Quality Commision report into Royal Bournemouth Hospital here

In the view of some patients and staff, it’s an indictment of the management and leadership of the Royal Bournemouth.

Indeed the summary of findings, the report says: “We found the trust overall was not ensuring effective leadership and governance across the hospital.”

In another telling section says the ongoing use of escalation beds when wards or units were full was “dangerous and could not meet any patient’s needs.”

And stroke patients “did not always have the fast access urgent treatment that they needed.”

Sir Mike’s inspection team, which included doctors, nurses, managers, members of the public, CQC inspector and analysts spent two days at the hospital in October.

The team found that medical care, including older people’s care was inadequate with “widespread and significant negative views from patients and staff.”

But other services also required improvement, notably accident and emergency, surgical services and outpatients.

In some areas, care was not always safe, doctors and nurses did not feel supported at times and on some medical wards, frail patients were “at risk of harm.”

Staff told the inspectors that staffing levels on surgical wards at night “were not safe” and there was a risk of cross infection in outpatients.

In a particularly damning phrase, Sir Mike’s report says: “The seriousness of the impact of poor care on patients outweighed the many positive comments received about the hospital.”

Sir Mike added: “Whenever we inspect we 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?

“At Royal Bournemouth Hospital, we were told about basic nursing care which was not being given to patients on two medical care wards. We heard from five patients who told us they had been left to wet or soil their beds.

“The hospital had a high occupancy rate and there had been ongoing use of escalation beds when a ward or unit was full, even though these beds could not meet patients’ needs properly.

“The trust did not employ enough staff, even though it was fully aware that nearly all its beds were occupied all the time.

“Some patients were still not receiving the care they needed in a timely manner, and there was an ongoing high risk of this continuing.”

The CQC, England’s independent regulator of health and social care has already presented its report to a local quality summit including NHS commissioners, providers and regulators.

The summit will develop a plan of action and recommendations.

Inspectors will return to the RBH to report on progress.

The report’s conclusions

Is RBH safe? The report found care was not always safe; both doctors and nurses at times felt unsupported and under too much pressure due to staffing levels and skill mix within the areas where they worked. On some medical wards, including for frail older people, patients were at risk of harm. On surgical wards junior doctors told us the medical staffing level at night was not safe. In outpatients there was a risk of cross infection. However the services that were safe included maternity, critical care, children’s care and end of life care.

Is RBH effective? Many parts of the hospital were effectively managed and applied recognised clinical guidelines or national standards which means that recognised best practice was used to deliver treatment that met patients’ needs. The A&E and medical care services were not effective and there is a need to ensure greater external scrutiny of some measures, such as mortality rates.

Are services caring? Some aspects of care were not met in a timely manner. This was found to be inadequate on two medical care wards in particular and to a lesser extent, across medical services as a whole. Some people in the medical care wards, including older frail people, were left in soiled beds. However, there were many positive examples of caring in areas that included maternity, critical care, children’s care, outpatients and end of life care.

Are services responsive to peoples’ needs? Children’s care, critical care and end of life care were particularly responsive to people’s needs. However, improvements in one part of the hospital were not necessarily shared across all services. Some people felt that when they made a complaint, the trust was dismissive of their concerns. This meant that they either chose to have care elsewhere or continued to feel dissatisfied.

Are services well-led? Many departments and wards had effective leadership. However the A& E department required improvements and medical care services in particular were inadequate in this regard. While there was clear communication between the senior management and the trust’s board, this was less apparent for other staff and this was affecting staff morale.

My mum died of lack of care, says son of Dorothy Simpson

THE grieving family of a great-grandmother who died in the Royal Bournemouth Hospital have welcomed the findings of the damning CQC report.

Dorothy Simpson died after making a desperate call to her family telling them she was getting no help from staff at the Royal Bournemouth Hospital.

She told them she couldn’t breathe and when one of her sons arrived at Ward 3 less than 20 minutes later she had passed away and was alone, with an alarm sounding.

Her son, Steve, said: “I am very angry that she was so badly let down by Bournemouth Hospital.  They let her down and let her die.

“She didn’t die of her illness – she died of lack of care.”

Since the tragic death of 84-year-old Mrs Simpson in July her distraught family have complained, prompting a high-level inquiry.

Chief Executive Tony Spotswood admitted a catalogue of errors in Mrs Simpson’s care and admitted she should not have been left on her own and there was a breakdown in communication.

He also said the frequency of observations was not recorded, there was a delay in obtaining appropriate medication and staffing numbers were not in accordance with guidelines for a half-an-hour period.

In a letter to her family, Mr Spotswood said: “It is clear from our investigation that you and your family had a very poor experience whilst your mother was under our care, and for this I am extremely sorry.”

But Mr Simpson said: “It seems to be that they say sorry and then carry on behaving in the same way.

“If it was their mums or dads or their children then they would make sure things improved.  All they seem to do is try to protect themselves.”