Rivers Hospital

On this page

• 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 and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

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.

The service proactively identified and accommodated individual needs at the point of booking, including requests for interpreters, chaperones or wheelchair access which supported personalised and inclusive care. We reviewed 5 care records that children’s needs were assessed at face to face pre-assessment appointments. We saw staff reviewed traveling distances and where appropriate offered phone consultations to minimise disruption.

Staff maintained clear, accurate and up-to-date records of children and young people’s care and treatment, which were accessible to those providing care. Records were held in paper format, including relevant clinical information such as previous medical history and family history.

We reviewed 4 care records during the assessment. Embedded pre-assessment documentation took into account the holistic needs of the patient and was used to plan future attendances and support individual care requirements.

Staff assessed patients’ pain 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’ pain was addressed before they left the operating theatre to ensure it was controlled before transfer to the ward.

Staff shared key information to keep patients safe when handing over their care to others. Shift changes and handovers included key information to keep patients safe.

Service users that we spoke with praised clear communication particularly relating to post surgical support and treatment. Parents and guardians were provided with named contacts for queries.

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.

Children and young people receiving care and treatment, along with their parents and guardians, were triaged to see a consultant. We reviewed care plans for patients that were seen as part of the surgical procedure pathway. Staff inputted into policies relating to paediatric evidenced based care and treatment were compiled at a provider level. The service planned and delivered patient’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

The service was part of provider that delivered care and treatment nationally. Policies and procedures were standardised across the services for staff to follow locally. These covered a range of healthcare needs to support care delivery.

Leaders told us that the service participated in a range of internal audits that were benchmarked within the organisation with learning shared across the locations. These audits focused on patient risks and ensured treatment was in line with best practice. Audit results were reviewed at governance meetings and shared within the team to understand performance on clinical outcomes.

Managers provided new staff with appropriate induction this included completing eLearning and competency based assessments.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

There was a clear process for the escalation of a deteriorating patient including the responsibilities of the consultant and medical staff to ensure safe management of a patient that requires emergency treatment at the local NHS hospital. Staff told us that patients had timely access to test results and diagnostic imaging services.

Staff within children’s services, worked well across the hospital to support patients. Staff ensured key clinical information was clearly documented and reviewed at preassessment and shared appropriately as a patient moved between different services.

Information was shared between teams and services to ensure continuity of care. Weekly multidisciplinary reviews were held with staff of all levels across the children and young people services to discuss the needs of patients due for admission. Staff identified and discussed patients’ specific needs in review meetings and planned how these needs would be met.

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.

The service supported children, young people and their families to manage their health and wellbeing. Staff provided advice during appointments, including guidance on allergy management. The service promoted healthier lifestyle choices and, where possible, helped reduce future care needs.

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 both clinical expectations and the expectations of people themselves.

Managers and staff reviewed embedded audits to monitor patient outcomes. Managers used information from the audits to monitor delivery of safe care. We saw outcome Patient Reported Outcome Data Measures (PROMs) for tonsillectomy, circumcisions, grommets. The data showed consistent improved outcomes following surgery for reduced pain levels and days missed off school following a procedure.

The service monitored performance of children and young people’s outcome data to monitor and improve the quality of the service.

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.

We reviewed 4 records and found that consent was obtained at preassessment for surgical procedures. Staff supported informed consent by providing age appropriate information about procedures. For patients who might have impaired mental capacity, staff were able to describe how they would assess and record capacity to consent appropriately.

Staff understood Gillick Competence and Frasure Guidelines and supported children who wished to make decisions about their treatment. Gillick competency and Fraser guidelines help people who work with children to balance the need to listen to children's wishes with the responsibility to keep them safe. When practitioners are trying to decide whether a child is mature enough to make decisions about things that affect them, they often talk about whether the child is 'Gillick competent' or whether they meet the 'Fraser guidelines'.

We saw examples of staff following the admissions criteria and clinical safety when they did this on a decision-specific basis with regard to significant decisions.