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Newark Hospital Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 November 2016

Inspection areas

Safe

Good

Updated 9 November 2016

Effective

Requires improvement

Updated 9 November 2016

Caring

Good

Updated 20 October 2015

Responsive

Requires improvement

Updated 20 October 2015

Well-led

Requires improvement

Updated 9 November 2016

Checks on specific services

Medical care (including older people’s care)

Requires improvement

Updated 9 November 2016

Minor injuries unit

Requires improvement

Updated 9 November 2016

Surgery

Requires improvement

Updated 20 October 2015

Outcomes for patients using the service were not monitored regularly or robustly. There was limited evidence of local audits taking place.

There was a lack of clear vision or strategy for Newark Hospital and limited communication from senior management to the staff working within Newark Hospital. Monitoring of quality and safety of the service was not always robust or effective. Staff did not always feel actively engaged or empowered.

There was an effective patient safety incident reporting system and evidence of sharing and learning so as to improve care. There were sufficient staff to deliver safe care and treatment. Staff followed the trust policy to manage medicines safely, and all medicines were stored appropriately and recorded accurately. Good infection control practices were in place.

Care and treatment were evidence based and pain management was effective. A multi-disciplinary team approach was evident with good multi-disciplinary working in all the wards and well attended multidisciplinary team meetings.

Patients were positive about the individual care and treatment they received both on the ward and within theatre. There were processes in place to support patients living with physical or learning disabilities when coming to hospital for procedures.

Once referred for surgery at Newark Hospital, patients were able to attend within a reasonable timescale. The surgical services met the national target for treating people within 18 weeks of referral. Patients were satisfied with their care and appreciated a local service. Staff supported patients with individual needs and provided patients with useful information before their surgery.

End of life care

Requires improvement

Updated 22 July 2014

The trust had not implemented guidelines, protocols or documentation to all wards that provided end of life care.

There was no trust-wide co-ordinated multidisciplinary training in end of life care.

Discussions about the decisions relating to end of life care were not always documented in the medical notes. Patient’s choice for their place of care was not always documented.

There were systems in place to provide planned discharges; however, there were no systems in place for a rapid discharge at end of life.

There was no evidence of learning from complaints, incidents or audit of the care patients received at end of life.

Staff had 24-hour access to the John Eastwood Hospice by telephone, for symptom control and advice. There were systems in place to refer patients to the Palliative Care team.

There was no named executive director with a responsibility for end of life care, which meant that end of life care was not represented at board level or in the trust’s vision or strategy.

Outpatients

Requires improvement

Updated 9 November 2016