PATIENTS were put "at risk of harm" in some wards at Wexham Park Hospital, which were found to be falling below essential standards according to the findings of a recent health watchdog inspection.
Among the concerns highlighted by the Care Quaity Comission were standards of hygiene and cleanliness, patient dignity, medical notekeeping and staffing levels.
Heatherwood and Wexham Park Hospitals NHS Trust has been ordered to make urgent improvements at the hospital in Slough.
In May, a report from the CQC raised concerns about standards of care received by patients and the quality of nursing at the hospital. There was particular concern over care given at A&E, and the knock-on effect this had on other wards.
A warning notice was issued to the health trust as a result.
In an unannounced follow-up inspection in October, the findings of which have just been published, it was found that improvements had been made in some areas, but the hospital still fell short in others.
The Trust said it was disappointed not to have made all the improvements expected, but it was committed to further improve standards.
The CQC’s latest report said "significant improvements" had been made in some areas - particularly in managing capacity issues in its recently refurbished A&E unit and ensuring the movement of patients from A&E and onto in-patient wards.
It also listed a number of other areas where improvements had been made, such as storage of medicine, good care and good management in a number of wards, including neonatal.
But the report said there were still serious concerns over leadership and management of certain wards, highlighting the Acute Medical Unit, ward 7 and ward 4, and it has again ordered improvements to be made.
It said: "On these wards, we observed many instances of poor practice where the quality of care fell significantly below essential standards. Patients' privacy and dignity was not always respected; medical and nursing notes were not complete or up to date; there were poor arrangements for ensuring the confidentiality of patient records; and standards of hygiene and cleanliness were not maintained. These wards were also found to be consistently short staffed.
"The care some patients received was below essential standards and put them at risk of harm."
It added that these concerns were raised immediately with managers so that safety issues could be addressed as soon as possible.
The watchdog also found many areas of the hospital to be in need of refurbishment, while signage was described as poor and there were "inadequate arrangements" for maintaining facilities and equipment.
Many patient areas were "dirty and dusty", in some cases preventing them from being cleaned properly, while equipment was not always cleaned or replaced when needed.
The report also noted that breaches of care were not picked up through the Trust’s monitoring procedures, staff did not always comply with policies and procedures and there was sometimes poor communication between staff and management over patient safety issues.
It added that a number of staff members also raised concerns about bullying and harassment from managers and said they felt unable to raise concerns or suggest improvements.
It said: "In some instances staff raised concerns with us but told us they were reluctant to speak with us for fear of reprisal from their managers and asked not to be named."
A statement from the trust said the organisation had been working hard to recruit more employees against a backdrop of national staff shortages across the NHS.
It added it was in year two of a five-year refurbishment plan, with more than £15m already spent, which should address CQC worries over the state of the hospital buildings.
It said: "We are disappointed that we have not made as much improvement as the CQC believed we should have in five months. We are committed to making sustainable change and will continue to work hard to drive the improvements we all want to see."