An NHS trust which looks after two hospitals has been told it “requires improvement” for its end-of-life care.

The Care Quality Commission (CQC) carried out an unannounced inspection of the service provided by the Maidstone and Tunbridge Wells NHS Trust in March and April.

Inspectors visited wards and departments across both Tunbridge Wells Hospital and Maidstone Hospital and declared it need to improve in multiple areas.

The Trust provides care for nearly 600,000 people and employs more than 5,000 staff.

A report from inspectors found the malnutrition universal screening tool had “not always been used to identify and score nutritional and hydration requirements” once a person had moved onto the end of life (EOL) pathway.

During the inspection of EOL care, they also discovered not all staff had completed their safeguarding training.

As well as this, there was a reliance on limited information in some areas to measure the responsiveness, effectiveness, and quality of a service and risks were not always identified and recorded for all services.

When the CQC visited, it also looked at how well-led the trust was, in which in was rated as “good”.

A previous inspection, in 2018, rated Maidstone and Tunbridge Wells NHS Trust as requiring improvement for surgery and urgent and emergency services. In 2015 it was told to improve its outpatient and diagnostic imaging services.

These remain, as does a previous overall rating for the trust as “requiring improvement”.

Neil Cox, CQC’s deputy director of operations in the south, said: “We found an experienced leadership team who had the capability and integrity to ensure they had oversight of what was happening across the trust and make changes needed to improve people’s care.

“During our inspection of EOL services, we observed staff treating people and their loved ones with dignity and care.

“Staff took time with people to ensure they felt supported. They introduced themselves and were compassionate to those who were experiencing pain, discomfort or distress.

“However, while we found some excellent volunteer support for the trust, some services, including the EOL team and the specialist palliative care team, weren’t always available seven days a week.

“The palliative care team had one consultant employed by the trust.

“They provided consultant cover across both hospital sites and were responsible for reviewing everyone who had been identified as approaching the EOL pathway.

“After the inspection we were advised a second palliative care consultant had been appointed which would improve care for people.

“People nearing the end of their lives and placed on the EOL pathway were supposed to have an individualised care plan.

“However, the specialist palliative care team informed us this wasn’t always happening in a timely manner as people weren’t always identified as being end of life.

“There was a potential risk that people approaching end of life might not be reviewed appropriately, or staff looking after them might not be given adequate support and guidance which must be addressed as a priority.

“We will continue to monitor the trust, including through future inspections, and we look forward to find what future improvements have been put in place.”

A spokesperson for Maidstone and Tunbridge Wells NHS Trust said: “The CQC carried out a well-led review of the trust and reviewed one service, end of life care.

“We know there is still more to do and we look forward to developing our services and facilities further...”

“MTW was once again rated as good for leadership and has been rated as requires improvement for end of life care and we have already taken steps in this area to address the feedback from the CQC.

“As this was a focused rather than a full inspection the overall rating of requires improvement for the trust remains unchanged and is based on the findings of the CQC’s last comprehensive inspection in 2017.

“We are pleased the CQC recognised the compassion and care shown to patients by staff in every department and inspectors highlighted the commitment of colleagues to continually improving services in all areas of the trust.

“While we are proud of all our achievements in recent years, and want to thank colleagues for their hard work and dedication, we know there is still more to do and we look forward to developing our services and facilities further.”