Nightingale Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence on how the service provided was responsive. During the inspection in June 2022, we rated this key question as requires improvement. At that inspection, the service was in breach regulation 9 (person centred care). At this inspection, the rating has changed to good. This meant that the service had taken action to improve its responsiveness in relation to discharge planning.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and decided, in partnership with them, how to respond to any relevant changes in their needs.

Patients received care which met their needs and reflected their preferences.

Staff held regular one to one key working sessions with individual patients. This ensured they were aware of the needs and individual preferences of each patient and how these could be met by the staff team. Patient records were audited weekly to make sure that one to one sessions were taking place.

Patients were able to feedback on the service, raise concerns and share ideas for improvement through the weekly community meeting. The provider has a hospital wide patient forum which is chaired by the hospital director to be able to share from "ward to board." Patients used these meetings express any concerns and suggest improvements, for example improvements to the environment, any maintenance issues, feedback on activities and food choices.

Staff we spoke with recognised and respected the totality of people's needs. They always took people's personal, cultural, social and religious needs into account. They spent time getting to know each individual and to understand their needs and preferences

The service provided person-centred care that met the needs of individual patients. Care was well-planned from admission to discharge.

Staff supported patients to maintain contact with their families and carers. Patients could book the visitors room for any family visits to the hospital. Where appropriate carers family members were invited to ward rounds and discharge planning meetings.

Patients told us they were given a welcome pack on admission and orientated to the service.

The service provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

Ward teams had access to the information they needed to provide safe and effective care and used that information to good effect. The service collected reliable information and analysed it to understand performance and to enable staff to make decisions and improvements.

Staff had access to the equipment and information technology needed to do their work. The provider was in the process of improving their information technology and performance reporting systems.

The service made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. The service involved them in decisions about their care and told them what's changed as a result.

Patients, relatives and carers knew how to complain or raise concerns. Patients and carers told us they knew how to complain and would feel comfortable raising concerns with staff including the ward managers.

The service clearly displayed information about how to raise a concern in patient areas. The patient information pack contained information about how to make a complaint.

We saw from community meeting minutes that staff and patients discussed complaints and concerns in the weekly community meeting and staff fed back at the beginning of these meetings updates and what had changed since the previous meeting.

Staff understood the policy on complaints and knew how to handle them. Staff we spoke to understand the complaints process and supported patients to make complaints and feedback about the service. Patients received feedback from managers after the investigation into their complaint.

All complaints were discussed at the clinical governance and clinical improvement meetings. Any themes or trends identified were shared with the ward teams and the wider service.

Staff protected patients who raised concerns or complaints from discrimination and harassment.

The service treated concerns and complaints seriously. Managers investigated complaints and identified themes. Managers shared feedback from complaints with staff and learning was used to improve the service. Staff told us complaints were discussed in handovers, clinical governance and staff meetings, this information was used to inform patient care. The service used compliments to learn, celebrate success and improve the quality of care.

We looked at records of complaints received by the hospital within the last 12 months and found that these were overall addressed within expected timescales. Where there were delays patients were kept informed. All complaints and any actions from complaint investigations were tracked by the services compliance lead.

Quality Statement Score: 3

The service made sure that everyone could access the care, support and treatment they need when they needed it.

Staff ensured the needs of patients with mobility issues were met — for example, wheelchair users were placed in bedrooms at ground level or had access to lifts.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

Staff received training in equality, diversity and inclusion. At the time of inspection, 89% of staff had completed training in equality and diversity in care.

Staff were aware of the need to respect patients' pronouns, religious needs, and beliefs, for example where a patient had identified their gender as non-binary all correspondence about the patient used their preferred pronoun.

Patient’s human rights were protected. The provider had procedures regarding equality and diversity. Staff understood people’s right to receive care and support that met their individual needs. 88% of staff had undertaken training in autism awareness.

The service had access to interpreters when required. Written information could also be translated if a patient’s first language was not English, but this was not required for the current inpatient group. The activities and equipment provided were based on the interests and preferences of the patients

Managers and staff were aware of their responsibilities to prevent discrimination and inequality and provide treatment and support in an equitable way to all patients.

Patients told us they were fully involved in their discharge planning and decisions about their care and treatment. Patients were supported to make informed choices about their care and plan for the future. Professionals worked together to support them to achieve their goals.

Staff reported that they worked with patients collaboratively to make decisions about their care and treatment and prioritise what was important to them.

We reviewed 8 patient care records. Discharge planning was now clearly recorded in the patients care plan. The service had improved this area of work since the last inspection and was no longer in breach of regulation.

The provider collaborated with other independent hospitals, Community Mental Health Teams and NHS hospitals and services as required.

Staff confirmed and records demonstrated that discharge planning started as soon as the patient was admitted to the service. The service now offered a weekly free on-line after care group service to support patients post discharge from the hospital.

Staff completed comprehensive discharge summaries for all patients. Each patient had a comprehensive personalised discharge planning booklet. Where patients were due for discharge the plans in place were discussed during the morning hospital meeting.