Rivers Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients told us they had taken part in a pre-treatment assessment, prior to admission to the service. The assessment process identified key risks and allowed staff to assess each person’s individual needs and preferences.

Staff shared key information to keep patients safe when handing over their care to others.

Staff assessed patients’ pain and comfort levels and used recognised tools to do so. Staff gave pain relief in line with individual needs and best practice and assessed how effective this was.

Patients told us they received support to control pain and treatment side effects soon after requesting it. They felt their pain and other side effects was well managed.

Staff completed individual risk assessments and put care plans in place where risks were identified. They told us the electronic patient record (EPR) was difficult to use to regularly update risk assessments. There was no evidence this had caused harm to patients.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. All policies we looked at included creation and review dates and referenced current national guidelines. We also saw notice boards displaying up to date guidance for staff.

Staff fully and accurately completed patients’ fluid and nutrition charts where needed. The information was used to inform care planning and delivery.

The service delivered evidence-based care and treatment in line with Joint Advisory Group (JAG) standards. This accreditation is awarded to endoscopy services that pass strict safety and quality checks.

Staff used systems and processes to ensure they treated the correct patients throughout the patient journey. We followed a patient journey in the endoscopy unit and tracked patient care from admission. We observed handover of patient information including all that related to identification checking processes. The World Health Organisation (WHO) surgical safety check list was used to minimise the risk of harm.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people.

Doctors, nurses, and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

Staff reported healthy working relations across staff groups, including between medical and nursing teams. We saw and heard examples of effective team working which was based on mutual respect and trust.

Staff planned for discharges with consideration people’s individual needs, personal circumstances, ongoing care arrangements and expected outcomes. They started discharge planning at an early stage to ensure it was safe and appropriate for each person’s needs.

Staff held regular and effective multidisciplinary team (MDT) meetings when required to discuss individual patients’ treatment options, refer to additional services if required and improve the care provided.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Health promotion was part of care provided to patients. Staff worked collaboratively to assess all aspects of general health, and to give advice and support to promote healthy lifestyles.

Patients told us they were given information and advice about their physical health and emotional wellbeing. Support was available through individual therapeutic sessions as well as group-based programmes.

Staff told us they provided patients with advice on how to refer or gain access to external NHS services when required, such as for counselling, smoking cessation or alcohol liaison services.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent and that they met the expectations of people themselves.

The service provided patients with the opportunity to provide feedback. Leaders relayed positive patient feedback to the relevant teams. Patient letters and thank you cards were displayed for staff to see.

We reviewed patient feedback data from the Private Healthcare Information Network (PHIN) from the previous 36 months. For the question of overall experience 97% (6031 respondent’s) reported excellent or very good ratings.

We saw evidence of changes being implemented because of patient feedback. For example, steps being taken to improve communication with patients when chemotherapy treatment changes.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gained patients’ consent for care and treatment in line with legislation and guidance. The most appropriate doctor sought consent for procedures and discussed the benefits, potential complications, risks and alternative treatment options. Staff checked patients’ at several stages, including immediately prior to treatment.

Patients told us they were involved in decisions about their care and treatment. They were able to describe the risks and benefits staff had discussed with them.

We observed staff seeking verbal consent before providing care or treatment. Staff involved patients in decision making at all levels.

Staff told us they could access interpreters to support patients to give informed consent when required, including for British Sign Language interpreters and face to face interpreting services.