Inspectors underwhelmed by Hillingdon Hospital have rated it as "inadequate", while the Trust is rated as "requiring improvement" after a major inspection.
The Care Quality Commission, the care watchdog, was particularly unimpressed by safety at the hospital, which along with leadership was ranked as "inadequate".
Effectiveness and responsiveness at the hospital was also deemed to "require improvement", while the hospital did receive a "good" rating for being caring.
Inspectors from the CQC focused on Hillingdon Hospital from March 6 to March 8 and inspected eight core services that had been ranked as needing improvement at the last visit. Two of these, Urgent and Emergency acre, and surgery were downgraded to "inadequate".
Patient safety, has been downgraded to inadequate by inspectors after finding "deterioration in infection prevention and control", poor recognition of sepsis and issues with medicines that were stored.
At the previous inspection, the levels of staffing were raised as an area of concern, and this time the issue has remained, with some services lacking "enough permanent nursing and medical staff to ensure the provision of safe care and treatment."
The inspectors also had issued with the record-keeping, and screening for MRSA pre-admission at the hospital.
Other areas highlighted by inspectors for improvement was a lack of audits taking place at the hospital. Another area of concern for inspectors was the overcrowding of Accident & Emergency services, although Hillingdon Hospital is now in the process of building an expanded A&E .
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The trust is responsible for Hillingdon Hospital in Pield Heath Road and Mount Vernon Hospital in Northwood, which is run in cooperation with East & North Hertfordshire NHS Trust. Mount Vernon was not inspected although its previous results brought up the average for the Trust to "requires improvement".
Leadership across the Trust was also examined between April 24 and 26.
Altogether, it employs 3,300 staff and covers a catchment of about 350,000 people in Hillingdon, "and increasingly to those living in the surrounding areas of Ealing, Harrow, Buckinghamshire and Hertfordshire".
Despite the largely negative report, inspectors were also keen to highlight examples of "outstanding practice", which it ways was found in "maternity, children and young people’s services and End of life care".
The Inspectors said: “Staff treated patients and their families with dignity, kindness and respect. We observed positive and compassionate interactions between staff and patients.”
They also stated that: “Staff provided emotional support to patients to minimise their distress (and) involved patients and those close to them in decisions about their care and treatment."
Of the eight core services inspected, end of life care, services for children and young people improved. Maternity was also ranked "good".
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Chief Executive, Shane DeGaris admitted that the Trust's performance was simply "not good enough": "We will use this report to help us make improvements wherever they are needed, including learning from those areas within our own Trust that have managed to improve their ratings.
"It is important now for all staff that we collectively focus our efforts on the actions required to improve services in a sustainable way for our patients.
“We are pleased however that a number of our core service areas have improved, with some areas of outstanding practice recognised, and that the care and commitment of our staff has been acknowledged throughout the report.”
The chairman of the Trust, Richared Sumray added: "We must now show what I know we are capable of doing and why our staff work in the NHS which is to work together to provide throughout the hospital, safe, efficient and well led services of a consistently high quality that our patients need and deserve."