CONCERNS about safeguarding and staffing levels have been raised in a new report by a health watchdog after an inspection of the children’s emergency department at Dudley’s Russells Hall Hospital.

The Care Quality Commission (CQC) has published a report today (Thursday April 6) following an inspection at the hospital, run by The Dudley Group NHS Foundation Trust.

The unannounced focused inspection of the paediatric emergency department was carried out in February after concerns were raised about the safeguarding of children and young people who attended the department.

Inspectors found systems were not always effective to protect young patients from abuse and improper treatment and there was a lack of awareness of the impact of risk of known safeguarding factors to influence decisions around a child’s care and treatment.

The report said staff did not actively use agreed screening tools to help identify children with additional risks and vulnerabilities and there was a lack of professional curiosity evident within records and with regard to safeguarding children with known vulnerabilities.

Inspectors also found there were not enough staff to care for patients and keep them safe or meet recommended staffing guidelines.

Charlotte Rudge, CQC’s deputy director of operations in the Midlands, said: “When we inspected the paediatric emergency department at Russells Hall Hospital we found some areas that needed improving to ensure children and young people who attend the department receive appropriate care and their needs are met.

“How staff were implementing safeguarding policies was our biggest concern.

“There was a safeguarding children’s policy in place which explained roles and responsibilities. However, staff didn’t always follow this which could place young people at risk. The understanding of policies and how to follow them was varied with some staff able to articulate how they’d manage concerns and others were unable to give examples.

“This included when a child was known to be vulnerable, there was a lack of awareness in how to assess or treat them while safeguarding them effectively.

“It was concerning that nursing staff shortages resulted in shifts operating without the required staffing levels. While many NHS services and those in the wider care sector also face staffing challenges, the trust must find ways to minimise the risk this poses to people in its care.”

The report, however, conceded the trust was proactively trying to address the staffing shortages and that a training package for paediatric staff and managing mental health in children’s services was being developed.

The CQC’s deputy director for the region said: “It was positive that leaders were proactive in recruiting new nursing staff and had developed recruitment events as well as inviting prospective staff for tours of the hospital and creating interactive videos for prospective applicants.

“It was also good that the trust was planning an 18-month conversion programme that could be offered to registered nurses wanting to convert to being registered children’s nurses.

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

The CQC said the trust has since provided a comprehensive action plan, with evidence, highlighting how concerns have been or will be addressed.

Chief executive Diane Wake said the Dudley Group has been working with the CQC to address concerns and make improvements and she added: “Where issues and concerns were raised with the trust, we took immediate action and provided assurance to the CQC of these immediate actions.

“We have improved safeguarding training compliance which now stands at 100 per cent among nursing staff in the department. Our safeguarding team visits the department daily, daily safeguarding audits have been implemented and awareness sessions have been held for staff on professional curiosity.”

She said the trust has been holding regular recruitment events to attract staff to address nursing shortages and she added: "More than 850 people attended our New Year, new career event in January and we have another recruitment event planned for April.

"We also hope to increase the number of registered children’s nurses through our 18-month conversion programme."

No new ratings were given following the inspection, so the trust’s overall rating remains ‘requires improvement’.