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ARROWE PARK HOSPITAL: Report praised hospital’s covid response

ARROWE PARK HOSPITAL: Report praised hospital’s covid response

Image: LDRS

Wirral’s main hospital has been boosted by a report which praised its measures for controlling the Covid-19 pandemic.

Inspectors from the Care Quality Commission (CQC), which regulates health and social care services in England, turned up unannounced on February 23 to assess how good Arrowe Park Hospital was at preventing and controlling the spread of coronavirus.

Although some flaws which increased the risk of infections spreading were found, the report was a very positive one on the whole.

Inspectors visited wards 11, 22 and 33, as well as the emergency department, acute medicine unit, urgent medical assessment centre and the discharge hospitality centre.

They also observed public areas and staff rooms to check social distancing practices were being followed.

Commenting on the report, Karen Knapton, CQC’s north west head of hospital inspection, said: “When inspectors visited Arrowe Park Hospital, they were impressed by the effective processes in place to support standards of infection prevention and control in order to keep patients safe.

“The trust had developed a Covid-19 safety bag. This was a paper bag, including masks, wipes and hand gel, which was given to all patients.

“The trust told us this had been received well by patients and visitors.

“Staff told us about daily huddles to discuss infection prevention and control including responsibilities, any problems identified and recent incidents.

“It was reassuring to find that staff felt respected, supported and valued and that there was an open culture where staff could raise any concerns without fear.”

Due to the limited focus of the inspection, the overall rating of Arrowe Park Hospital did not change and remains ‘requires improvement’, the second-worst rating out of four.

This rating was given due to findings from reports in recent years and is not a reflection of anything seen in this inspection.

The positives

Much of the report was positive, praising the hospital’s standards in many important areas.

One part of the document read: “The trust had effective systems to manage and eliminate nosocomial transmission of Covid-19.

“Nosocomial transmission of an infection is transmission which occurs in hospital.

“The number of nosocomial infections peaked in the week ending 10 January 2021 and had significantly reduced since then.

“The proportion of patients with Covid-19 in hospital beds also reduced in the same period as did the number of patients dying from Covid-19.”

Some of the broad conclusions of the report were encouraging for Arrowe Park.

The report continued: “All areas we visited were visibly clean and dust free. Touch free hand washing sinks were available throughout the hospital with soap dispensers.

“Soap dispensers included hand washing instructions. In the emergency department majors area hand washing sinks were situated outside of each patient cubicle.

“The trust had a culture that promoted the delivery of high quality and sustainable care.

“The trust had appropriate policies and operating procedures related to infection prevention and control.”

Management of staff at the hospital was also said to be a positive feature of the hospital.

The document added: “The trust had a clear vision and plan for continuously improving practices related to infection prevention and control and an action plan to meet identified goals.

“Staff felt respected, supported, and valued. The trust had an open culture where staff could raise concerns without fear.

“They were focused on the needs of patients receiving care.”

The problems

There were however several issues with infection control procedures at the hospital.

The report said: “Doors to patient side rooms in some areas, where patients were nursed due to their infection status, were left open increasing the risk of spreading infection.”

Elaborating on this, the document added: “During our inspection we saw six patients on wards 11 and 22, nursed in side rooms due to their infection status, where the door to the room had been left open.

“This is a risk because it reduces the isolation of patients, which prevents the spread of disease to others.

“We raised this with senior managers during our inspection and they explained those patients had other associated risks which required the door to be left open such as high risk of falls or dementia.

“They told us staff conducted dynamic risk assessments for each patient and recorded this in the patient record.”

The report reveals that managers were worried about this, the document continued: “At the time of our inspection, the trust produced a standard operating procedure which outlined key actions to be taken when nursing a patient in a side room where the door needed to be kept open.

“However, managers did not have assurance that the dynamic risk assessment was always recorded in the patient notes. Senior managers told us wards 11 and 22 were identified as an area of concern.

“Senior leaders had recognised the need to upgrade ward facilities and had plans to improve the ward environment starting in March 2021. Temporary units had been procured to move wards to whilst upgrades took place.”

There was also a specific problem with personal protective equipment (PPE), as the document stated: “Not all staff in areas caring for Covid-19 positive patients were clearly able to articulate [PPE] requirements in relation to the wearing of eye protection.”

It is understood that Arrowe Park Hospital is running targeted education for its staff to ensure appropriate eye wear is used when undertaking certain procedures.

Staff at the hospital were not vaccinated as quickly as had been hoped.

The document continued: “The trust had a target to give all staff their first Covid-19 injection by the end of January 2021.

“At the time of our inspection they reported 74.4% of staff had received their first dose of vaccination by 2 March 2021 and 9.1% of staff had received their second dose.

“The trust offered all staff a seasonal influenza injection and in December 2020 82.8% of staff had received their influenza injection.”

Incidents relating to IPC (infection, prevention and control) problems were also found.

The report added: “We reviewed incident reports and saw 450 incidents relating to IPC were reported.

“We saw seven incidents were reported as moderate harm and one as a patient death. There were 17 incidents rated as moderate risk.

“The trust had completed rapid reviews for four incidents and reported one as a serious incident and conducted an incident investigation.

“We reviewed a rapid review following an incident and saw it identified problems with patient care, immediate actions taken, lessons learnt and identified the people involved and actions relating to staff skills and competency.”

Some rooms were also too warm according to inspectors.

On this, the report stated: “The windows did not open in some side rooms. This meant that rooms could feel uncomfortably warm.

“We did not see fans being used during our inspection. However, following the inspection the trust told us fans were available if required and there was a standard operating procedure in place for their use.

“We were told that all windows had been coated with a film to help control the heat particularly during summer months.”

Janelle Holmes, chief executive at Wirral University Teaching Hospital, said: “It is fantastic that the systems and processes we have put in place to ensure we keep our patients and staff as safe as possible from the spread of infection have been recognised by the CQC.

“The team has worked tirelessly to develop and apply innovative IPC measures to protect our patients and staff, which has been all the more important as we have adapted our working during the pandemic.”

Hazel Richards, chief nurse at the trust, added: “Staff have worked hard over the past year to ensure patient and staff safety are our top priorities and we have an open culture where we continue to learn.

“IPC has been at the forefront of all our activity and remains a constant focus.

“We welcome the report from the CQC, as it recognises the considerable improvements made and will help us to further improve our services for patients.”

Words: George Morgan, Local Democracy Reporter


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