North Devon District told to improve wound care

The Care Quality Commission (CQC) has told Northern Devon Healthcare NHS Trust that it must improve its systems for managing woundcare and for dealing with patients who are at risk of developing pressure sores.

The CQC issued a press release on the 25th August, stating that inspectors who had recently visited North Devon District Hospital in Barnstaple found that care plans and other patient records were not always completed. While they did not find individual cases of poor care, they did find a failure to fully assess and plan all aspects of patient care which could mean that some people might not get the care they needed.

The inspection process looked at areas of possible concerns relating to patient care which are currently being investigated through safeguarding procedures involving NHS Devon, Devon County Council, Devon and Cornwall police and the CQC.

The inspection focused on the hospital's current compliance in four related areas.

• How pressure area care is managed.
• How well the hospital works with patients with complex needs or with communications difficulties
• Consent and assessing mental capacity for patients.
• Meeting nutritional and hydration needs.

Inspectors spent three days at the hospital in July, meeting patients and staff, checking records and visiting medical and surgical wards. They found that the trust was compliant with three of the four standards which were reviewed. These three standards were (1) respecting and involving people, (2) consent to care and treatment, and (3) meeting nutritional needs. However the hospital was not found to be compliant with the standard on the care and welfare of patients.

Inspectors found examples where patients' care plans, wound care plans and pressure area assessments were not recorded properly. They found eight examples of wound care plans where the records were unclear about when treatment started or whether improvements were being properly monitored. Inspectors concluded that people were at risk of receiving inappropriate care because care plans and monitoring records were incomplete. Failure to fully assess and plan the delivery of all aspects of care and treatment meant that their needs might not be met properly.

Ian Biggs, Regional Director of CQC in the South West said that the trust must now provide its plans to show how it will achieve full compliance.

He said: "In a busy hospital, good patient records are essential. Doctors and nurses depend on them to ensure that their patients are getting the right care throughout the day and night, when shifts change and different staff come on duty or take over responsibility for a particular person’s care.

"Patients we met on the wards had no complaints about their care, although we have identified some key areas of concern, mainly around pressure damage and wound care, where lack of assessment and care planning could place people at risk.

"When we raised the issue of records at North Devon Hospital earlier in the year, the trust gave us a detailed action plan which included some key changes to the documentation being used to ensure good care and treatment. They told us they would be fully compliant by the end of September.

“We are satisfied that the trust is already taking action. If we had any further concerns for people’s safety, we would take action straight away. In the meantime we will continue to monitor the hospital – and we will check to see that all the improvements have been made in further unannounced inspections.”

Need help ensuring your healthcare organisation is compliant with the CQC standards of care? Speak to one of the Words Worth Reading Ltd experts to see how we can help.