Medical care at Broomfield Hospital has been rated as ‘requires improvement’ by the health watchdog – six months after the hospital was given the same rating overall.

However the Chelmsford hospital has improved from when the Care Quality Commission (CQC) last inspected the medical care core service in September 2018, when it was rated ‘inadequate’.

During the inspection, they identified that there was a lack of a robust induction process and competency assessment to ensure that temporary staff were competent to carry out their roles and responsibilities.

Mid Essex Hospital Services NHS Trust submitted an action plan following publication of the inspection report in January 2019, which rated the hospital overall as requiring improvement

During this latest inspection, carried out in May, CQC inspectors visited the Emergency Short Stay (ESS) ward, Acute Medical Unit (AMU), Writtle ward and Baddow ward and found the trust had taken measures to put processes in place for “robust induction and competency assessments, to ensure that temporary staff were competent to carry out roles and responsibilities”.

However the CQC added that focus needs to continue on the oversight and progress of systems and processes, to ensure induction and competency checks completed in line with trust induction policy for temporary staff “are fully embedded”.

Staffing issues were consistently cited for the reason the service had been going downhill, with pressures on permanent staff having an impact on their ability to deliver safe care.

In particular, inspectors found staff vacancies of up to 60 per cent and a high reliance on external agency nurses to fill gaps in rotas.

The report found some wards were frequently staffed exclusively by agency nurses, especially at night to cover the shortage, but processes to ensure temporary staff were competent for their roles had not been applied.

Staffing challenges limited staff’s capacity to always deliver compassionate care, and dignity was not always respected, especially in relation to a bedbound patient found on Braxted ward who was kept in the same clothes for five days.

A statement from the CQC said: “The trust had taken measures to put processes in place for robust induction and competency assessments, to ensure that temporary staff were competent to carry out roles and responsibilities.

“This has ensured progress from the September 2018 inspection.

“The trust had reviewed the induction policy and the associated induction checklist to address the concerns that were identified at our September 2018 inspection. The concerns included the lack of a robust induction processes and sufficient internal competency checks for agency nurses.”

The statement said changes made by the hospital were shared appropriately and inspectors saw evidence that the senior leadership team had communicated with staff.

“The trust was making progress with imbedding the reviewed induction policy and associated orientation checklist trust-wide,” added the statement.

“In addition, the trust was developing and implementing effective governance process to provide oversight of the service.

“There was a clear governance process to ensure the changes were embedded in practice from ward level up to the board.

“However focus needs to continue on the oversight and progress of the systems and processes, to monitor the induction and competency checks are completed in line with trust induction policy for temporary staff, are fully embedded.”

Broomfield Hospital has been approached for comment.