CQC identifies improvements needed following inspection of St Mary’s Hospital

The Care Quality Commission (CQC) has found that improvements are needed at St Mary’s Hospital on the Isle of Wight following an inspection of its urgent and emergency care and medical care services.

The hospital, operated by Isle of Wight NHS Trust, serves a population of around 140,000 people, with a higher proportion of residents aged over 65 than the national average.

Inspectors visited the hospital in February as part of the CQC’s ongoing monitoring programme. Following the inspection, the regulator issued a Warning Notice requiring the trust to improve the clinical management of the emergency department waiting room.

The hospital’s overall rating remains Good.

Urgent and emergency care

Urgent and emergency services remain rated Requires Improvement. Following the latest inspection, the CQC rated the service as Requires Improvement for Safe, Effective, Responsive and Well-led, while the Caring rating fell from Good to Requires Improvement.

Inspectors found the service was in breach of legal regulations relating to safe care and treatment, the emergency department environment and the overall management of the service.

The report identified concerns about long waiting times, with the trust not consistently meeting the NHS four-hour emergency department standard. Some patients waited more than 12 hours for an inpatient bed after the decision to admit them had been made.

Inspectors also found staff had limited visibility of the emergency department waiting room, creating a risk that deteriorating patients may not be identified quickly. Environmental concerns included patients being cared for in corridor spaces that obstructed access to treatment cubicles, as well as insufficient management of ligature risks for people experiencing a mental health crisis.

The CQC also reported that staff could not always access information about patients’ mental health risks, potentially affecting the safety of both patients and staff.

Despite these concerns, inspectors found that ambulance handover performance remained strong, with most handovers completed within 15 minutes. The report also highlighted positive multidisciplinary working, particularly with dementia, learning disability and end-of-life care teams, and noted that staff felt able to raise concerns with leaders.

Medical care

Medical care, including services for older people, remains rated Good overall. The CQC rated the service Good for Effective, Caring, Responsive and Well-led, while the Safe rating was downgraded to Requires Improvement.

Inspectors found the service was in breach of safeguarding regulations and said the trust would be required to produce an action plan to address the issues identified.

The report found staff treated patients with kindness, dignity and respect and involved them in decisions about their care. Inspectors also identified a positive learning culture, with staff reporting incidents appropriately and leaders sharing lessons learned to improve patient safety.

However, the CQC found there were not always enough staff available to provide the level of one-to-one care some patients required. Inspectors also identified gaps in safeguarding knowledge and mandatory training, raising concerns that some staff may not always recognise or escalate potential safeguarding issues.

The CQC said it will continue to monitor the trust’s progress and assess whether the required improvements are implemented following the Warning Notice and action plan.

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