A spot check on the Royal Berkshire Hospital by national inspectors has uncovered the challenges faced in protecting patients and staff from Covid-19 and other infections during the pandemic.
The Care Quality Commission visited the hospital on 29 April 2021 and published its findings on 1 July 2021.
Issues found by inspectors
- 76 patients had caught Covid-19 in the hospital and died, leading to patient safety investigations and a ‘Duty of Candour’ to explain to families what had happened
- people visiting relatives were sometimes not given PPE until they were inside wards, while others were given it at entrances
- hand gels and masks were not in the direct line of sight of people arriving at A&E and were on tables or walls without any signage pointing them out
- patients arriving at A&E did not have their temperature or Covid-19 status checked until they saw a health professional and could mix with others in the waiting room
- high levels of staff sickness at the peak of the first wave meant there were not enough staff to work only in ‘hot' or 'cold’ areas to reduce cross-infection
- ward staff felt some outbreaks in the early stage of the pandemic were due to a lack of side rooms and isolating facilities for Covid positive patients
- a Covid outbreak occurred among renal patients getting dialysis and was reported as a serious incident
The CQC’s report says: ‘The trust had communicated with every family member of patients whose deaths were linked with hospital acquired COVID-19 outbreaks and informed them of the investigations. They had a summary report sent to them, or the trust was in the process of doing so. They were offered the opportunity and support to ask the trust any questions they might have.’
Overall, inspectors said while ‘the changing landscape of the COVID-19 infection will continue to be challenging’ they ‘felt assured that systems and practices were sufficient to manage and adapt to the ongoing and future challenges’.
Steps taken by the hospital
- in the event of an outbreak, staff got to wear more protective ‘FFP3 masks’
- the trust has adequate supplies of PPE to maintain safe care
- ‘Point of care’ Covid testing was introduced for all patients on arrival, before being admitted to wards and then again on day 3, day 5 and then every 72 hours
- patients needed a negative swab up to 48 hours before discharge (unless they’d tested positive in the past 90 days) and their result passed on to receiving services
- people discharged to a care facility within a 14-day isolation period were discharged to a ‘designated care setting’
- 98% of staff had had their first vaccine
- staff carried out twice weekly lateral flow testing, or did weekly PCR testing on high risk/outbreak wards or twice weekly PCR testing in oncology and haematology
- people coming in for planned surgery needed to take a Covid-19 test 72 hours beforehand, self-isolate and then be tested 3 and 5 days after surgery
- spacing was increased between beds in wards and windows opened for ventilation
- only one dialysis patient was transported to and from hospital at a time
- staff rooms had maximum occupancy numbers put up on doors
- temperature checks and Covid questions were introduced at A&E reception
- patients stayed in touch with family by booking in a call via a ward tablet device.