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'Toxic culture', 'feral senior staff' and medicine storage issues identified at ED

Care Quality Commission report into pilot inspection at Noble's Hospital

A toxic culture, a feral attitude from senior medical staff and ineffective and outdated procedures are among the failings identified at the Emergency Department at Noble's Hospital.

The Care Quality Commission has sent a report to the Department of Health and Social Care and Manx Care following a four-day pilot inspection in June.

The CQC asked five questions - is the service safe, effective, well-led, responsive and caring? In four of these five areas, the inspectors found the service was not meeting expectations.

Two areas - the culture in the department and its leadership - have been escalated to the Department of Health and Social Care, for the department to put in place an action plan for Manx Care to make change.

In its findings on culture, the inspection highlights concerns that staff did not feel respected, and that their health and wellbeing lacked support.

Issues around bullying and a blame culture were identified, while the attitude and behaviour of senior medical staff was described as 'feral'.

Health Minister Lawrie Hooper discussed the findings:

Problems around the storage of medication were also highlighted, with three errors resulting in harm, severe harm or death identified between December 2021 and April this year.

A further 17 medicine errors involving high risk medication were also flagged, while the report said the service did not manage patient safety incidents well.

Paul Moore is Manx Care's Director of Nursing:

The one area singled out for praise was the caring nature of the department's staff, who were described as treating patients with compassion and kindness.

The CQC said those working in the emergency department spoke passionately about wanting to make a difference for patients and their families.

The inspection was a four-day pilot, with a full inspection due to take place later this year, during which Manx Care says it hopes many of these issues will be found to have been rectified.

You can hear more from Minister Hooper and Mr Moore's conversation with Manx Radio's Sian Cowper by listening to our Mannin Line Special podcast.

The full report is due to be released on the Isle of Man Government's website later today.

The CQC says it has a ‘service-level’ agreement with the Department of Health and Social Care to provide advice and assistance in developing a system of independent inspections. 

It’s confirmed all reports are subject to a ‘thorough quality assurance process’ prior to publication and the CQC does not have a statutory role on the Island.

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