CQC downgrades urgent and emergency services at Calderdale Royal Hospital

The Care Quality Commission (CQC) has downgraded urgent and emergency services at Calderdale Royal Hospital from Good to Requires Improvement, following an inspection in February.

The hospital, run by Calderdale and Huddersfield NHS Foundation Trust, provides urgent and emergency care to people in Halifax and the wider community.

Following the inspection, the service retained Good ratings for caring, responsive and well-led, while safe and effective were both downgraded from Good to Requires Improvement.

CQC found staff were working hard to meet people’s needs under significant pressure but identified staffing shortages which inspectors said must be addressed to ensure people receive safe care.

Staff told inspectors they did not always have enough time to provide the standard of care they wanted and sometimes missed breaks because of demand. Inspectors saw some people waiting for pain relief and identified an example where a person repeatedly requested a drink but did not receive one.

Long waits were also highlighted. While teams were working together to free up beds and anticipate periods of increased demand, CQC found some people waited more than 24 hours. Specialty doctors also did not always review people within an hour of being requested, in line with professional standards, contributing to delays.

Inspectors raised concerns about falls prevention after finding risk and bed rail assessments were not always completed for people at risk of falling. CQC observed people with raised bed rails where a risk assessment had not been carried out.

Safety concerns were also identified in rooms used by people experiencing mental health difficulties, with some containing ligature risks and items or fixtures that could potentially be used for self-harm.

In the paediatric emergency department, inspectors saw visitors being admitted without security checks about their reason for attending, creating a risk that people could enter the department inappropriately.

Several staff also raised concerns about the location of the same day emergency care unit, which did not have emergency call bells and was described by staff as isolated from the main department.

CQC found medicines were not always administered at the correct time, including time-critical medication used in the treatment of Parkinson’s disease. Infection prevention measures were also not consistently followed.

There were positive findings. Managers provided support to staff following difficult events or incidents, and staff told inspectors they felt supported by leaders and colleagues. Staff also identified and recorded people’s cultural needs, including language and dietary requirements, and aimed to meet them.

CQC said leaders had recognised the need to strengthen the department’s response to deteriorating patients and were working to introduce a new electronic system to remind staff when observations were required.

The regulator has told leaders where rapid and continued improvements are expected and said it will continue to monitor the service closely.

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