'Visibly dusty' emergency department told to improve

A 'visibly dusty' hospital emergency department has been told it still needs to improve by a watchdog.

An unannounced inspection took place at Cumberland Infirmary, in Carslisle, over two days in February, followed by another visit on 18 March.

The Care Quality Commission (CQC), which subsequently issued a warning notice to the trust in April, said it found some areas of the department were "unclean" and people were facing "lengthy" waits.

The North Cumbria Integrated care NHS Foundation Trust (NCIC) said it was making improvements to facilities. It added the department, which was originally designed for about 30,000 patients a year, was now seeing 70,000.

Although the service kept its overall grading of 'requires improvement' from 2023, the rating for safety has been lowered from 'requires improvement' to 'inadequate', while the grading for caring also declined, from 'good' to 'requires improvement'.

NCIC chief nurse Dr Gill Findley said the trust accepted "fully" the CQC's findings, but was disappointed.

She added the trust took "immeadiate action" after the warning notice, including assigning a healthcare assistant or registered nurse to the department's waiting room and establishing new processes to ensure mental health risk assessments were carried out punctually.

The CQC said its inspectors found the department "appeared visibly dusty and, in some areas, unclean" and resuscitation bays and temporary escalation spaces were "cluttered with equipment".

It added staff were kind and worked hard, but did not always follow "good hand hygiene practices or bare below the elbow principles" and did not ensure people had individualised care plans in place.

The watchdog also said leaders needed to address "significant backlogs of incidents that had not been reviewed or investigated yet".

CQC director of operations in the North East, Roger James, said people had reported concerns over "delays and lengthy waits", with some on chairs and trolleys for prolonged periods because of a lack of beds and treatment areas.

"Additionally, there weren't enough cubicles to accommodate demand, with several people being cared for in temporary escalation spaces," he said.

"These environments didn't always have call bells and didn't support people's privacy and dignity."

Findley said £4m had been invested into urgent and emergency care services, and an Urgent Treatment Centre had been set up and put into action.

She said the trust had been "very open" about crowding challenges and were "clear that corridor care is unacceptable".

The chief nurse said she was "particularly disappointed" with clutter and hygiene findings.

"We all agree that there is no excuse for this, and we have been working hard to reiterate the importance of adhering to infection prevention standards," she said.

The CQC said it would continue to monitor the service closely.

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