Archived: Tarporley War Memorial Hospital

Updated 15 January 2020

Tarporley War Memorial Hospital is operated by Tarporley War Memorial Hospital Trust. It is based in Tarporley, Cheshire. The service primarily serves the communities of western and eastern Cheshire and Vale Royal.

Tarporley War Memorial Hospital was founded in 1919 by local subscription, it is funded by a small NHS contract which covers one third of its operating costs. The remaining funding is achieved through private self-paying patients, one off payments from NHS commissioners and charity fundraising. The hospitals registered charity fundraises through a local charity shop and other charitable initiatives.

The hospital has 16 inpatient beds (separate male and female wards; five side rooms and one double room), they mainly cater for NHS ‘step-down’ patients, which may be referred from two local NHS Trusts. NHS step-down patients may include those who do not require acute care, (e.g. a fall, but no fracture) and patients transferred from an acute hospital who are waiting for a package of care to return home. They may also have patients who require active rehabilitation before returning home. The hospital also provides private respite care for local patients, the majority of whom reside in a five mile radius of the hospital. We looked at all wards during the inspection.

The hospital also has a “mini minor injuries” drop in service and an outpatient’s service operated by external providers but using hospital facilities and nursing staff.

The hospital provides a ‘step up’ service for people who needed extra care and help and ‘stepdown’ services for those who no longer required an acute hospital bed. They also provide rehabilitation, respite care and palliative care.

The hospital has a registered manager, who is also the director of the hospital. The hospital is registered with CQC for regulatory activities; diagnostics and screening procedures, treatment of disease and disorder and surgical procedures.

During our inspection; We spoke with seven patients and relatives. 15 members of staff, volunteers and one trustee. We reviewed seven sets of patient records.

Tarporley War Memorial Hospital was last inspected 1, 2 and 13 February 2017 and was rated requires improvement.

Updated 15 January 2020

Tarporley War Memorial Hospital is operated by Tarporley War Memorial Hospital Trust. Tarporley War Memorial Hospital was founded in 1919 by local subscription, it is funded by a small NHS contract which covers one third of its operating costs. The remaining funding is achieved through private self-paying patients and charity fundraising. The hospitals registered charity fundraises through a local charity shop and other charitable initiatives. The in-patient unit specialises in the rehabilitation of the elderly, intermediate care and supporting terminally ill and palliative patients. There is also a day care facility and they offer respite care.

The hospital also has a “mini minor injuries” drop in service and an outpatient’s service operated by external providers but using hospital facilities and nursing staff.

The hospital is registered to provide the following regulated activities:

• Diagnostic and screening procedures

• Surgical procedures

• Treatment of disease, disorder or injury.

  The hospital director is the registered manager, supported by a matron.

  We inspected this service using our comprehensive inspection methodology. We carried out the unannounced visit to the hospital on 30 and 31 July 2019.

  We inspected all inpatient areas of the hospital excluding the mini minor injury unit.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this service improved. We rated it as Good overall.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• The service-controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.

• The service used systems and processes to safely prescribe, administer, record and store medicines.

• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.

• The service provided care and treatment based on national guidance and evidence-based practice. Staff protected the rights of patients in their care. The hospital utilised the expertise of the local community NHS trust where they needed specific expertise.

• All those responsible for delivering care worked together as a team to benefit patients. They supported each other to provide good care and communicated effectively with other agencies.

• The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care. The sister, staff nurses and health care assistants told us they worked closely with the NHS physiotherapy and occupational therapy teams to ensure patients received the correct level of care or support in relation to discharge planning.

• People could access the service when they needed it and received the right care in a timely way.

• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

• Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service. We found good levels of governance and management interaction.

However,

• Volunteers in the service were not trained to recognise and deal with potential safeguarding concerns.

• Volunteers at the hospital did not have appropriate training in order to support patients with swallowing problems.

  These were reported to the provider at the time of the inspection and appropriate mitigating actions were taken.

  Following this inspection, we told the provider that it should make improvements to help the service improve. Details are at the end of the report.

  Ann Ford

  Deputy Chief Inspector of Hospitals (North West)

Updated 15 January 2020

We rated this service as good because it was safe, effective, caring and responsive. Lead ers had the skills and abilities to run the service and staff were focused on the needs of patients receiving care.