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CQC Inspection Report – A Letter to Parents and Carers From Jonathan Stephens, Deputy Chief Executive

welcome_alder_heyDear parents and carers,

As you may know, the Care Quality Commission (CQC) has published a report today following its inspection of Alder Hey in May.

We have welcomed the report, particularly as it highlights many areas of best practice and high quality care that everyone at Alder Hey should be very proud of. One of its strongest messages is the fact that all of our staff are absolutely committed to the care and treatment of children and young people.

Successes

Some of the key successes which the report mentions are:

  • Nurses are caring and compassionate, and treat children and young people with dignity and respect. The Trust also has highly skilled, competent and well-supervised doctors.
  • Standards and outcomes are good when compared to other children’s hospitals.
  • The hospital is clean, well maintained and infection control rates are managed effectively.
  • Access to advice and information is good for children and young people, their families and carers both during and after their hospital stay.
  • Staff in Surgery provide safe services to children and young people and care is person-centred. They are well trained and recovery rates are favourable compared to other similar hospitals.
  • There is strong medical and nursing leadership in the Intensive Care Unit and Neonatal Surgical Unit.
  • We have a robust and comprehensive mortality review process.

Our ratings

The CQC uses its inspection process to ask five key questions of NHS Trusts:

  • Is it safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive to people’s needs?
  • Is it well-led?

The CQC then uses its findings to rank organisations on a four point scale:

1. Outstanding
2. Good
3. Requires improvement
4. Inadequate

We are delighted to tell you that palliative and end of life care was found to be ‘outstanding’. We have been rated ‘good’ for caring for children and young people, and providing effective care.

However, the CQC identified that improvements are needed in some areas, in providing safe and responsive care, and being well-led.

This has led them to give us an overall rating of ‘requires improvement’.

In the areas inspected, the ratings are as follows:

  • Palliative and end of life care – Outstanding
  • Accident and Emergency – Good
  • Medical care – Good
  • Neonatal services – Good
  • Surgery – Good
  • Critical care – Requires improvement
  • Outpatients – Requires improvement
  • Transitional services – Requires improvement

Areas requiring improvement

We would like to reassure all our patients, parents and families that Alder Hey provides a safe service to all our children and young people. The CQC did not highlight any issues that we weren’t already aware of, some of which have already been resolved. Their conclusion is that we provide a service which is safe overall.

The main issues highlighted which they want us to respond to are:

  • Address staffing shortfalls. Nurse staffing levels must also be appropriate in all areas, without substantive staff feeling obligated to work excessive hours or additional shifts.
  • A longer-term solution must be found for the medical leadership on the High Dependency Unit.
  • Children and young people must receive one-to-one support in the isolation pods on the High Dependency Unit when required.
  • Clinical records must be available in the Outpatients Department.
  • Nurses must follow the Trust’s policy on the safe administration of medicines.
  • The Trust must address the shortfalls in governance and risk management systems and improve the timely completion of investigation of incidents and ‘Never Events’ to learn from them systematically and avoid recurrence.

All of these issues are being tackled already and some have already been resolved. They will now be included in an action plan which we will publish in September.

There is no doubt that Alder Hey is staffed by committed and caring people who are passionate about our patients and families. Our action plan will now allow us to make improvements quickly that will enable us to demonstrate excellence in everything that we do.

If you have any particular concerns please contact our Patient and Family Support on pals@alderhey.nhs.uk or call 0151 252 5161 / 0151 252 5374.

Best wishes,

Jonathan Stephens
Deputy Chief Executive

Your comments

  • I’m surprised the hospital received the overall level it did when 5 out of 8 areas were judged to be good or outstanding but I’m sure the CQC know what they are doing. Staff shortages are usually associated with inadequate funding though aren’t they so more funding would mean more staff. I trusted Alder Hey with the life of my child once and I would do it again.

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