Last year we carried out an unannounced inspection of an establishment which resulted in a number of shortfalls against the HTA’s licensing standards, some of which were classified as being ‘Critical’. A critical shortfall is a shortfall which poses a significant risk to human safety and/or dignity and is the most severe level of shortfall requiring immediate action.
Since that inspection, we have been working closely with the establishment to develop and oversee a Corrective and Preventative Action (CAPA) plan, and the hard work appears to have paid off.
One year on, it was great to see significant improvements in a range of areas including the facilities, equipment, practices, and management.
As well as the majority of HTA standards now being met, there were many areas of excellent practice:
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The Trust invested in modernising the facility which includes upgrades to the security arrangements, body store facility and a new post-mortem room.
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It was clear that all staff in the department took great pride in their work. The support they provide for bereaved families was exceptionally compassionate and kind and maintaining the dignity of the deceased was paramount.
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The training package for staff was excellent. As well as the mandatory and technical training packages, the establishment have gone ‘over and above’ to support staff in the difficult work they undertake. Staff are fully trained in the patient journey which has included visits to hospital wards and the local crematorium.
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The Trust has also invested in the newer members of staff supporting professional qualifications, and there are two young and enthusiastic individuals training to be Anatomical Pathological Technologists (APTs).
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There is a fantastic culture within the mortuary with a clear support network accessible to all. There is a speak-up guardian, supportive follow-up process and a willingness to learn from mistakes which allows for a continual encouragement to improve.
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The management within the mortuary was visible and effective. They were clear about how they expected the facility to be run and led by example.
I have been a Regulation Manager at the HTA for six years now inspecting over all sectors licenced under the Human Tissue Act 2004. It has brought great satisfaction to see the impact of the HTA’s advice, guidance, and ongoing engagement which in turn has contributed to maintaining dignity of the deceased and public confidence.
On the late journey home I thought to myself, ‘this is why I do what I do’.
Caroline, Regulation Manager, HTA.
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