The hospital trust in charge of Royal Oldham has been told its services must improve - with staffing levels and the morale of 'hardworking' NHS staff highlighted as areas of concern.

Inspectors from the Care Quality Commission (CQC) carried out an unannounced inspection of the Northern Care Alliance in August and September this year, publishing its report today (December 22).

At the Oldham hospital use of PPE, waiting times, and maintenance of the building were all criticised while the passion and commitment of staff were highlighted.

They found that some staff at the trust did not always feel listened to or valued, with some having reservations about raising concerns – though inspectors praised the trust’s vision and strategy.

Additionally, Royal Oldham’s emergency care department was highlighted for ‘outstanding practice’ in its training program to raise awareness around support for victims of domestic abuse.

It is the first inspection of the Northern Care Alliance, which was formed on October 1, last year, to manage Royal Oldham Hospital, Salford Royal Hospital, Fairfield General Hospital, and Rochdale Infirmary.

Inspectors looked at the trust’s leadership overall and then looked at some services in each hospital.

The trust has been rated requires improvement overall, and for being safe, effective, responsive and well-led. It has been rated good for being caring.

Inspectors said leaders were inconsistent in operating processes, with differences in policies and practice that didn’t always reflect best-practice guidelines.

However, inspectors said most leaders were clear about the need to review this.

Inspectors also found that staff were not always assured data collected was accurate, with staff not always able to find the data they needed to understand performance and make decisions.

For Royal Oldham specifically, the trust was told it needs to ensure there were sufficient numbers and skill mix of nursing staff to meet people’s needs.

The report found that Royal Oldham did not have enough staff to care for patients and keep them safe, with staff not always having training in key skills.

Additionally, Royal Oldham was found to not control infection risk well, with the trust told it needed to improve the wearing of PPE by staff.

Maintenance of the hospital was criticised, with the premises said to not always keep people safe. Wait times at the hospital were also criticised.

However, staff were said to treat patients with compassion and kindness, respecting their privacy and dignity.

Staff working ‘incredibly hard’

Karen Knapton, CQC head of hospital inspection, said: “When we visited Northern Care Alliance, we found staff working incredibly hard under pressure to deliver the best possible care to patients.

“During our inspection, we found there had been positive changes in the leadership team since the acquisition, and new leaders, led by the chief executive, had already identified issues and started to make improvements.

“Their initial focus was on maternity services, patient safety, waiting times and addressing health inequalities. These improvements weren’t fully embedded at the time of our inspection.

“It was clear that leaders didn’t always actively and openly engage with patients and staff to plan and manage services, although plans were in place to improve this.

“However, it was reassuring that the trust engaged well with external stakeholders and local partners to help improve services for patients.

“Additionally, the trust reported and investigated complaints and incidents. However, these weren’t always completed in a timely manner, and learning wasn’t always shared with relevant departments across the trust.

“Our inspectors found staff didn’t always feel respected, supported and valued.

"However, they remained focused on the needs of patients receiving care.

“Leaders have started to make changes to improve patient care and know what further improvements are needed. We will return to check on progress to ensure these are embedded and sustained across the trust.”

Trust responds

Dr Owen Williams, Northern Care Alliance Chief Executive, said: “The care and safety of patients and the wellbeing of our colleagues remain central to what we are about and we are determined to work together to get better results for the people we serve.

“We fully accept the CQC’s judgement and their recommended areas for improvement and as the CQC have acknowledged, some improvements are already being made but they do not go far enough at this moment in time.”

Dr Williams thanked colleagues working across the organisation for their ongoing care and commitment during a time of unprecedented demand.

He added: “I am pleased that the inspectors recognised what I have found out to be true in my first year as CEO, which is that many colleagues are totally caring and are working incredibly hard under a level of pressure the likes of which many of us have not experienced before.

“There is a lot of work to do but our patients can be assured that their safe care and treatment is of utmost importance to us and, on behalf of all my colleagues at the NCA, I would like to thank them for their understanding and support as we work very hard to turn this around.”

The full report can be read on the CQC website.