Springfield Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. We checked that people were safe and protected from bullying, harassment, avoidable harm, neglect, abuse, and discrimination.

At our last assessment we rated this key question good. At this assessment, the rating remains good.

This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

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

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events.

The service had a current incident reporting and reviewing policy, which reflected national guidance. The service managed patient safety incidents well. Staff recognised and reported incidents and near misses in line with the policy. Managers investigated incidents and shared lessons learned with the whole team and the wider service. We saw the service had weekly updates. This was visible to all staff and summarised incidents, identified any lessons learnt and instructed on next steps and changes in process. Managers ensured actions from patient safety incidents were addressed and progress of actions was monitored.

The service provided mandatory training in key skills to all staff. Managers monitored mandatory training and alerted staff when they needed to complete updates. Staff were given time to complete mandatory training. Modules included training on recognising and responding to patients with learning disabilities. The data showed 98% of staff within the oncology and endoscopy departments had met this target.

There had been no reported never events for medical care in the preceding year. Never events are serious, preventable safety incidents which should not occur if the available preventative measures are followed.

Staff told us they were able to identify and report risks. Where there was an immediate risk of harm to patients or others staff felt confident to intervene to prevent harm from occurring.

Staff we spoke to understood their responsibility for Duty of Candour. Duty of Candour is a legal requirement for all health and social care providers to act in an open and transparent way with people receiving care. This means when something goes wrong that causes, or could cause, significant harm, the provider must inform the person (or their family), explain what happened, offer an apology and outline next steps. There was an up-to-date policy in place, and we saw evidence of it being applied appropriately.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service provided care and treatment for both private fee-paying, insured and NHS patients. NHS patients accessed the service through GP referrals. The service used the same admission criteria for both private and NHS patients. These criteria set out the service limitations. Patients were assessed prior to treatment to reduce risk and ensure suitability for the service.

Where patients did not meet the required criteria, referrals were declined and patients were redirected to the NHS.

When overall responsibility for a patient’s care and treatment transferred to another service provider, such as the NHS, this was conducted under an established agreement with the local NHS provider. Whenever a patient required a transfer, a review was undertaken to support ongoing learning and improvement. Data indicated that 3 oncology patients and 1 endoscopy patient required a transfer in the previous 12 months during their care at the service. These transfers were undertaken in accordance with the service's transfer policy

The service used National Early Warning Score 2 (NEWS2) as a standardised system to detect early signs of clinical deterioration in adult patients, and we observed this being used during our assessment.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

Staff understood how to protect patients from abuse. Staff received and completed adult safeguarding level 3 and children's safeguarding level 3 training. Compliance was 95% for adult safeguarding and 100% for children’s safeguarding. There was a current safeguarding policy, that reflected national guidance.

Staff knew who to inform if they had concerns. Expert safeguarding advice was available to support staff from adult and paediatric safeguarding leads. Staff knew how to contact them and were supported to raise concerns.

We saw evidence of safeguarding concerns being identified and investigated in accordance with the service policy. Leaders gave staff feedback following safeguarding investigations.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe and supportive.

The service worked with patients to understand and manage risks. Treatment and care met patients' needs in a way which was safe and supportive.

Staff understood how to identify and manage risks. They provided endoscopy patients with comprehensive appointments to discuss risk factors and plan care before and after the procedure. Staff reviewed risk assessments on admission and, where changes in risk were identified, discussed any amendments to treatment plans with patients and their relatives or carers.

Patient records included risk assessments such as venous thromboembolism (VTE), manual handling, risk of falls and infection control risks.

The service had processes in place to support staff with understanding and managing patient risks and deterioration. This included NEWS2. We observed this being used during our assessment.

Patients told us they felt listened to, risks had been explained and they were involved in decisions about their care and treatment.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service was designed to reduce the risk to patients in patient areas and included features such as safe flooring and handrails.

Staff ensured fire safety equipment was available and had been serviced. Staff kept fire exits clear and free from obstruction.

Staff kept equipment visibly clean and well maintained. Staff told us all items of equipment were readily available and any faulty equipment was repaired or replaced in a timely manner.

Staff conducted daily safety checks of specialist equipment. Emergency resuscitation equipment was available in the areas we inspected, and equipment check logs were complete and up to date. All the emergency resuscitation trolleys were tagged to minimise the risk of tampering.

Patients could easily access call bells. Staff positioned call bells by patient beds and showed patients how to use them to summon help.

In line with Joint Advisory Group on Gastrointestinal Endoscopy (JAG) accreditation guidance, all areas in the endoscopy theatres and decontamination areas were well maintained and designed to support safe, efficient patient flow. JAG accreditation is a nationally recognised quality mark for endoscopy services.

Staff appropriately controlled access to clinical areas to maintain patient privacy, dignity and safety.

Staff managed cytotoxic waste safely and in accordance with the national guidance.

However, during our assessment, we identified two pieces of equipment with expired Portable Appliance Testing (PAT). PAT is the process of routinely inspecting and testing portable electrical equipment to ensure it is safe to use and does not present an electrical hazard. Staff immediately removed these items from use, and leaders advised that servicing had been arranged. Records and data provided demonstrated that all other equipment was within the required testing dates.

We scored the service as 3. The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service employed sufficient clinical staff, including nursing and support staff with the right qualifications, skills, training, and experience to keep patients safe from avoidable harm and to provide effective care and treatment. Staff received advanced notice of their shifts.

Managers provided temporary bank and agency workers with a local induction to the areas in which they worked.

Staff said they felt the service was safe and that they were able to take breaks during their shifts.

Patients said staff met their needs in a timely manner, and we observed staff responded quickly to patient requests for help. We saw staff attend to patients in a kind and supportive way. Patients appeared comfortable and engaged in conversations, which reflected adequate staffing levels.

Patients were clear which doctors were involved in their care.

The service provided a specialist oncology pharmacist to support and manage chemotherapy medicines, which also ensured timely access to specialist advice when needed.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading appropriately.

The service managed infection risks well. Staff used equipment and control measures to protect patients, themselves, and others from infection.

We observed staff following infection prevention and control principles, including handwashing and the correct use of personal protective equipment (PPE). Staff working in clinical areas were bare below their elbows to allow for full hand decontamination.

Staff maintained clinical areas in a visibly clean and clutter-free condition. These areas had suitable furnishings that were clean and well-maintained. However, we observed gaps in the patient bed/chair space cleaning logs within the oncology service. The service provided assurance that bed and chair spaces were cleaned after each use and advised that any gaps in the records indicated that the space had not been used. This was in accordance with the service's processes.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs and preferences. They involved people in planning, including when changes happen.

Staff completed medicines risk assessments, including assessments for venous thrombolytic embolism (VTE), and prescribed appropriate prophylaxis if needed.

Staff stored medicines, including controlled drugs, securely and checked them regularly.

Staff told us they could access pharmacy support 24 hours a day, 7 days a week if necessary.

Staff told us pharmacy support helped ensure people had access to medicines they required, supporting continuity and safe supply. The service had access to specialist oncology pharmacy support, including an oncology specialist who managed chemotherapy medicines, which ensured timely access to specialist advice when needed.

Cytotoxic medications were stored and handled safely. Staff used an electronic chemotherapy prescribing system and there were systems in place to check chemotherapy medications before they were administered. The pharmacy only dispensed chemotherapy medications once the patient’s blood results had been checked and confirmed as suitable for chemotherapy treatment.