Coronavirus: Inspectors see nurses at outbreak hospital not wearing their masks or washing hands

Not all staff had been trained in wearing protective clothing or had access to goggles, watchdog report reveals

Shaun Lintern
Health Correspondent
Wednesday 07 October 2020 18:17
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CQC inspectors found patients were at risk of infection at the William Harvey Hospital in Kent
CQC inspectors found patients were at risk of infection at the William Harvey Hospital in Kent

Inspectors have criticised staff at an NHS hospital which saw a major outbreak of coronavirus on its wards after workers were seen not wearing masks properly and failing to use protective hand gel.

East Kent Hospitals University Trust had almost twice the national rate of hospital-acquired infections of Covid-19 between 30 June and 26 July, with 12 per cent of infected patients catching the disease on wards at least 15 days after being admitted.

The care watchdog the Care Quality Commission has taken enforcement action against the hospital after inspectors found a catalogue of errors that increased the risk of infection to patients.

This came after the regulator had issued the trust with a warning notice at the start of August when it learnt it did not have a named lead for infection prevention.

In a visit to the A&E department and medical wards at the trust’s William Harvey Hospital, in Ashford, Kent, during August, inspectors found not all staff had received training on wearing personal protective equipment (PPE). Some were seen to be not wearing PPE correctly.

It said nursing staff were seen not wearing masks correctly while on a Covid-19 ward while another nurse was seen not wearing their mask properly on a ward where there had been an outbreak of the disease.

In its report the inspectors said: “We saw a senior nurse ask nursing staff to wear their face mask correctly over their mouth and nose on six occasions on the Covid-19 ward. We saw a senior nurse ask a member of the nursing team to wear their face mask correctly over their mouth and nose on the outbreak ward.”

The CQC said at least seven members of staff had been seen entering and leaving a ward caring for patients suspected of having Covid-19 without using hand gels when they entered or left the ward.

In its report the CQC said patients with confirmed Covid-19 were not wearing masks in clinical areas or while being moved. Staff on the hospital’s Covid-19 ward told inspectors they did not have access to visors or goggles.

The report added: “The portable hand sink at the entrance to the Covid-19 ward did not have any hand towels. This meant staff were unable to dry their hands.

“Staff did not wash their hands on two of the four wards we visited.”

In A&E inspectors said staff there did not always wear their protective clothing correctly, did not take it off when entering a new clinical area and did not wear the right kind of PPE for some patients they were treating. They also said triage of patients with Covid-19 symptoms was inconsistent.

Sanitisers at the two entrances to the A&E assessment area were empty and despite the CQC raising this, later that day they remained empty.

At one stage earlier this year the trust had twice as many deaths from Covid-19 as other hospitals. In July it tested all 9,000 staff with 15 testing positive for the virus.

The CQC found cleaning schedules were only partially filled in for the two weeks before the inspection. It also witnessed five staff entering a small room with a lack of signs on some rooms saying what was the maximum number of people allowed in to maintain social distancing.

CQC’s chief inspector of hospitals, Ted Baker, said: “It is extremely disappointing to find that despite being warned about their hygiene, not enough work had been carried out to address infection control issues within the trust. It is particularly concerning during a time when infection control could never have been more important.

“We had reviewed the work carried out by East Kent Hospitals University Foundation Trust around infection prevention and control practices and issued a warning notice to them on 3 August. However, the scale of the concerns were so great that we carried out a focused inspection on 11 August.

“Following the inspection, we reported our findings to the trust so its leaders know what they must address. We used our enforcement powers by imposing conditions on the trust’s registration, to ensure people are safe.”

He said the issues were now being addressed but the trust would be monitored closely.

East Kent Hospitals University Trust is also at the centre of a maternity scandal after dozens of baby deaths and more than 130 babies being starved of oxygen at birth. An independent inquiry into maternity safety at the trust is being led by Dr Bill Kirkup.

Responding to the CQC report, interim director of infection prevention and control at the trust, Dr Sara Mumford, said: “This inspection took place two months ago and we took immediate action to make improvements.  

“Since the inspection, we have retrained staff in the correct use of PPE and hand hygiene, put in place additional checks for cleaning, hand hygiene and PPE, reviewed and strengthened our policies and are making physical changes to the hospital to support social distancing.

“Staff have worked incredibly hard throughout the pandemic to care for patients, and their care and safety remains our priority.”

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