FURTHER details have been revealed of the improvements required from an NHS trust that runs two key North-East hospitals, following a mixed inspection report.

The Care Quality Commission (CQC) this week published a report on County Durham and Darlington NHS Foundation Trust, which runs Darlington Memorial Hospital and the University Hospital of North Durham.

Although the CQC identified areas worthy of praise, the trust's was given an overall rating of 'requires improvement'.

In response, trust chief executive Sue Jacques pledged to take the trust to an 'outstanding' rating within two years.

As well as previously reported cleanliness issues at accident and emergency departments, other issues requiring improvement include:

* Sufficient numbers of suitably skilled, qualified and experience staff must be present on wards, particularly where patients are receiving non-invasive ventilation;

* The trust must undertake a review of the skills, knowledge and capabilities of nurses to complete accurate and timely care plans that meet the needs of patients;

* Patients must be placed on the most appropriate ward to meet their needs and the trust must ensure patient records, including those for patients awaiting discharge, are kept up to date, are patient-centred and contain relevant information;

* Clinicians must record mental capacity assessments for patients who are unable to participate in discussions about whether they receive CPR in the event of a cardiac arrest.

Inspectors also highlighted several areas of good practice across the trust. These include:

* An 'exceptionally caring' critical care service at Darlington, with highly individualised care and attention to detail for patients and their relatives;

* Safety huddles have been implemented on wards at Durham;

* There was consistently positive feedback from patients and relatives about community nursing teams, with care being described as excellent;

* The dietetics team was committed to improving nutrition; work it had undertaken had been published and shared nationally;

* The County Durham Rapid Early Specialist Team service provided early senior and multi-disciplinary assessment for frail older people, which led to safe discharge from hospital;

* There was a family nurse partnership established to provide intensive support for teenage mothers.

Ms Jacques said: "Because the CQC assessment is broadly in line with our own self-assessment, it means we have already made good progress in areas where it was identified that improvements could be made and we have action plans in place to continue delivering further improvements."