Royal Bolton Hospital: Plan to improve spotting 'child abuse'

This comes with the release of a Care Quality Commission report this week which reduced the Minerva Road hospital’s emergency department’s ‘safe’ rating from ‘good’ to ‘requires improvement.’

Though the inspectors found staff were well versed in protecting adult patients from abuse, less then half of them had done the training needed to recognise the same in children.

The report said: “Staff did not always have the training on how to recognise and report abuse in children.

Royal Bolton's emergency services have faced huge pressures recently (Image: Bolton NHS Foundation Trust)

“Nursing staff did not always receive training specific for their role on how to recognise and report abuse in children.

“The Royal College of Paediatric and Child Health sets out that clinical staff should undertake level 3 children's safeguarding training.

“Of the 138 staff required to complete the training, 54 members of staff, (39 per cent) had completed it meaning that the service could not be assured staff had the knowledge to recognise children at risk of harm or abuse.

“Following the inspection, managers informed us that an improvement plan was in place and that progress of this was being monitored by divisional and trust wide governance processes.”

The inspectors visited on November 23 and 24 last year and also found that people going to the emergency department for mental health treatment had been forced to endure ‘long delays.’

Triage times also did not always meet national expectations, according to the report.

But though the emergency department’s ‘safe’ rating was brought down, the emergency services’ overall rating was kept at ‘good’ overall, as does Bolton NHS Foundation Trust’s rating as a whole.

CQC deputy director of operation in the North Karen Knapton said: “When we inspected the emergency department and medical services at The Royal Bolton Hospital, we saw a good level of care across most areas, but some improvements were needed in the emergency department to ensure people are safe.

“We were impressed that emergency department staff not only knew how to identify and treat sepsis; they were also supported by an electronic reporting system to record symptoms.”

She added: “However, people attending with mental ill health often experienced long delays in being assessed.

“The service had recognised this and updated its procedure to include hourly checks with people to ensure they were safely cared for and their nutrition and hydration needs were met.”

But the inspectors also had words of praise for much of the work done by doctors, nurses and other staff members.

Ms Knapton said: “Medical services were run by an effective leadership team, with staff who were clear about their roles and responsibilities and treated people with respect and kindness.

“Doctors reported that nurses were competent and quick at recognising deteriorating patients and that consultants were responsive to any requests to review patients.

“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people can continue to receive a good standard of care.”

Managers say they are working to ensure patients waiting for mental health assessments are safe and that risks are mitigated

They also say that they are increasing compliance with staff training in key skills, such as safeguarding children.

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Chief nursing officer Tyrone Roberts said:  “We welcome today’s report from the CQC, and we will use these findings to focus our attention on areas where we know we can improve and make an even greater difference to what our staff and patients experience.

“Given the sustained pressures and challenges our workforce has faced over the past three years, I’m so proud that their compassion, care and dedication shone through during the inspection.

"I would like to thank them all for embodying Bolton’s values by continuing to deliver such high-quality care and doing all they can to look after our communities every single day.”