Archived: Samuel Johnson Community Hospital

Samuel Johnson Community Hospital is one of the three locations that Burton Hospitals NHS Foundation Trust provides services from. The other locations are Queen’s Hospital and Sir Robert Peel Community Hospital. We inspected the hospital between 24 and 25 April 2014.

Samuel Johnson Community Hospital provides a range of services including rehabilitation, care of older people, general medical care, outpatients, minor injuries service, diagnostics and midwifery-led maternity services. The inspection team inspected the minor injuries unit (MIU), medical care (including older people’s care); and maternity services during this inspection.

In the last 12 months 30,000 patients attended the minor injuries unit. Before and during our inspection we heard from patients, relatives, senior managers and other staff about some key issues that were having an impact on the service provided at this trust. We also held a listening event in Burton where patients and members of the public were given an opportunity to share their views and experiences.

Why we carried out this inspection

Burton Hospitals NHS Foundation Trust had a significantly higher than expected mortality rate from April 2012 to March 2013. As a result, the trust was included in Professor Sir Bruce Keogh’s review of trusts in 2013. The overview report Review into the Quality of Care and Treatment provided by 14 Hospital Trusts in England is available on the NHS Choices website. The Keogh review identified a number of areas of good practice. However, the report identified a number of areas of concern, such as no systematic approach to ensure the collection, reporting and action on information about the quality of services. It also found that there was a lack of support for junior doctors, and that medical staffing levels and skills mix were not appropriate and equipment safety checks had not been carried out.

We inspected this hospital as part of our in-depth hospital inspection programme. When we inspected the trust in April 2014, 14 of the 61 recommended actions following the Keogh inspection had still to be completed.

Overall, Samuel Johnson Community Hospital was rated as good. This hospital was rated as good for providing services that are effective, caring, responsive and well-led. However, it requires improvement in providing safe services.

Our key findings were as follows:

• Ward staff were committed to delivering high quality care and saw patient experience as a priority.
• Recruitment is a recognised challenge for the trust, with some wards below establishment. Bank, agency and locum staff were used to fill vacant posts and some staff worked additional hours. In some areas there was a high dependency on temporary nursing staff.
• There were procedures in place for staff to learn from incidents and implement changes.
• There were systems in place for monitoring the safety of the environment and equipment.
• Staff had access to and attended mandatory training.
• Clinical areas were clean and there were policies and procedures in place detailing cleaning schedules.
• Documentation for children attending the MIU lacked specific prompts and did not include evidence such as the names of parents/guardians accompanying children or if the child or family had contact with social services.
• Translation services were available on request.
• There was a trust complaints policy and procedure for managing complaints. Staff were made aware of the outcome of complaints. However, the trust set a timeframe of 35 working days to respond and this was not always met.
• The hospital does not always meet the needs of all patients living with dementia.
• Some specific equipment, such as adjustable beds for people who were at a high risk of falls, was not always available.

We saw areas of outstanding practice including:

• The arrangements to cover unexpected midwife absences. A system alerted staff by a text message to inform as many midwives as possible that replacement staff were required. Staff were very positive about the efficiency of this system.

However, there were also areas of poor practice where the trust needs to make improvements.

Importantly, the hospital must:

• Take action to ensure documentation for children attending the MIU records appropriate information.
• Take action to ensure the care for people living with dementia is embedded throughout the hospital.
• Review the systems and processes for responding to complaints within the agreed timescales.

In addition the hospital should:

• Consider reviewing the availability of equipment such as adjustable beds.

Professor Sir Mike Richards

Chief Inspector of Hospitals