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RehabilitationJul 2, 2021

'Cluttered' NHS rehabilitation gym posed infection prevention and control risks, says CQC report

A Care Quality Commission (CQC) inspection team found a rehabilitation gym at Medway Maritime Hospital in Gillingham, Kent, was so full of ‘clutter’ that it could not be cleaned properly.

The stinging criticism of the way in which equipment was stored in the gym was based on observations made during a ‘short notice focused inspection’ of infection prevention and control (IPC) measures at the hospital in May. It appears in a CQC report that was published yesterday (1 July). 

 

Photo Credit: Shutterstock
The 'clutter' hampered efficient environmental cleaning and posed a risk to IPC, the CQC said

DJO Global
DJO Global

While the CQC report makes a number of positive observations about Medway NHS Trust’s approach to IPC, it also calls for a number of improvements. 

'Cluttered' rehab gym

The report notes that all the areas visited by the CQC team ‘were visibly clean and tidy’ – except the ‘cluttered’ rehabilitation gymnasium.

A corner of the rehabilitation gymnasium was also used as an open layout office with limited space between desks to enable social distancing. While the whole environment was visibly clean, it was cluttered and almost the entire floor space was packed full of rehabilitation equipment [CQC report]

Therapy staff told the inspectors that rehabilitation sessions were being conducted on wards and that the gym was mainly used to store equipment, such as exercise machines and walkers. Apparently, the original storage facility had been converted into an office space for another department.

The report continues: ‘A corner of the rehabilitation gymnasium was also used as an open layout office with limited space between desks to enable social distancing. While the whole environment was visibly clean, it was cluttered and almost the entire floor space was packed full of rehabilitation equipment.'

Risk posed to infection control

As a result of the clutter, cleaning routines were hampered, the report states: ‘This did not allow efficient environmental cleaning and posed a risk to IPC. The therapy lead informed us the health and safety team had completed a risk assessment and the therapies team had submitted a business case to source alternative storage facility,’ the report notes.

Leadership and governance issues

The CQC inspectors also commented on leadership issues. 'Leaders had the skills but did not always have the capabilities to manage IPC,' the report notes. 'They did not always have the capacity to support all staff, due to the lack of leadership stability and vacancies within a new IPC team. The trust had an ongoing active recruitment to key positions to strengthen the capacity.'

Turning to governance issues, it notes: 'The trust did not have comprehensive governance systems to support IPC standards. Governance structures were not clear, and it was not clear how and what was communicated within them. It was not clear who had oversight, and if the trust board was fully sighted on IPC issues.'

Make-up of CQC team

The inspection team was led by Catherine Campbell, head of hospital inspection at the CQC, and included a CQC inspector and a specialist adviser with experience in infection prevention and control.

The team members spoke to 18 members of staff, including allied healthcare professionals, nurses, doctors, matrons, managers, and housekeeping and support staff. They also observed practice and reviewed six sets of patient records and medication charts to assess compliance with national guidance.

About the trust

Medway Maritime Hospital, the only hospital run by the trust, serves a population of more than 424,000 people in the Medway and Swale areas of Kent. It employs about 4,400 staff and provides a wide range of specialist and general hospital services to almost half a million patients a year.

Response from trust

Chief executive George Findlay said that keeping patients and staff safe was the trust’s ‘number one priority’. ‘I am pleased that the CQC has acknowledged the importance that the trust places on having robust infection prevention and control measures in place and has identified some areas of good practice. However, we know that there is still more work for us to do.'

Dr Findlay added: ‘We have implemented an improvement plan to further improve our infection prevention and control practices, and to ensure our staff are supported in consistently providing safe, high quality patient care.'

In response to CQC feedback, the trust said it took ‘immediate steps’ to implement improvements. These included:

  •        additional staffing to support the IPC team
  •        increased compliance with IPC standards and the launch of a more robust process for investigating hospital acquired infections
  •        improved governance and audit processes to ensure compliance with infection prevention and control standards

 

For more information, visit: https://www.cqc.org.uk/provider/RPA

 

 

 

Author: Ian A McMillan
DJO Global
DJO Global
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