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Archived: St Mary's Hospital

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Inspection report

Date of Inspection: 16 July 2013
Date of Publication: 15 August 2013
Inspection Report published 15 August 2013 PDF | 79.64 KB

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 16 July 2013, observed how people were being cared for and talked with people who use the service. We talked with staff.

Our judgement

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

One patient told us the staff always asked if there was “anything else you need?” and also said they [the staff] “involve me in everything”.

Staff told us there were good opportunities for training courses that would meet professional responsibilities or enhance their abilities to carry out their roles. The provider may wish to note we were told the staffing levels had been, and continued to be low and that this had hindered access to the training available at times. The ward sister confirmed a new staff nurse was due to commence work at the hospital later this year. We were also told the fluctuating care needs and numbers of patients at the hospital meant there could be periods when staff did not get the opportunity to practice a particular skill and that it was important they had access to refresher training (for example, suturing).

We saw from training records that staff did have training opportunities and reminders were posted in the office about forthcoming training available. There were a large number of clinical text books available on the hospital ward, for example, trauma injuries and palliative care.

Medical cover in the hospital was provided by three local general practitioners. The staff we spoke with were positive in their comments regarding the support received from the GPs. Staff at the hospital also worked in the minor injuries unit and all trained nurses had received appropriate training for this. We were told that annual emergency trauma training was provided by a visiting accident and emergency consultant who attended from the mainland. The specialist team from Cornwall provided anaphylaxis training annually. The hospital sister was a trained trainer, and provided training regarding adult and paediatric life support.

Staff told us they had lead roles for certain areas of care. For example, blood transfusions and syringe drivers. Additional training had been undertaken by these nurses to ensure that they were up to date with their knowledge when offering support and guidance to other staff. The provider may like to note we were told staffing levels meant attendance at meetings relevant to lead roles was not always possible.

We were told about emergency plans that were in place to transfer people to the mainland and how they would work. This included arrangements with other agencies for travel by sea and air.

Staff told us they felt supported by the ward sister and hospital manager. One person said relationships with colleagues were “excellent” and they all supported each other. Another told us “everyone worked together to benefit the patients”.

Supervision is a vital tool used between an employer and an employee to capture working practices. It is an opportunity to discuss on-going training and development. Some professions have to show they have had formal supervision sessions in order to maintain their right to practice. The provider may wish to note that staff said they did not receive formal supervision, but there was an ‘open-door policy’ and that they could talk with the hospital or ward manager at any time. Staff did confirm annual appraisals had taken place and during this process training needs were identified. It is noted that the provider had a supervision system in use at another location, and the provider stated their intent to ensure frequent and regular supervision was introduced and embedded in the culture of St Mary’s hospital. The ward sister confirmed clinical supervision training was arranged for later in the year.

Two members of staff told us handovers took place at the start of each shift. They said these were beneficial to the people who used the service as well as a means of peer support, and clinical supervision for each other.