Paulton Memorial Hospital

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good.

At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

Staff within the service have based patient care around individual needs and preferences. For example, asking if a patient would like to be assisted to walk to the toilet or to use a commode.

People and their relatives were asked by staff how they managed at home or before coming into hospital and care was planned around their wishes and hopes for the future.

Staff empowered patients to make their own decisions about their care and treatment. For example, by using communication aids to meet patients communication needs. This enabled the patient to have their hydration needs met by pointing to which drink they would prefer.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Managers planned and organised services, so they met the changing needs of the local population. For example planning for winter bed pressures as part of the NHS response to increased demand for beds in the winter.

Facilities and premises were appropriate for the services being delivered and the ward was accessible for patients and visitors.

The service had systems to help care for patients in need of additional support or specialist intervention. For example, patients with cognitive difficulties were carefully monitored to minimise risk.

The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers. This included working with local community teams and social workers. For example, discharge plans included input from community partners and other social care providers which was coordinated by staff on the ward.

The ward was designed to meet the needs of patients living with dementia. Clear signage was appropriate on bathrooms.

Staff supported patients living with dementia and learning disabilities by using ‘This is me’ documents and patient passports. These documents contain readily available information about a patient to use in an emergency and to record likes and dislikes, communication needs and other specialist information.

Staff understood and applied the policy on meeting the information and communication needs of patients with a disability or sensory loss.

The service had information leaflets available in languages spoken by the patients and local community.

Managers made sure staff, and patients, loved ones and carers could get help from interpreters or signers when needed. Staff told us they knew how to access these resources.

Patients were given a choice of food and drink to meet their cultural and religious preferences. Patients commented how good the food was and the variety of options on offer at each meal.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Staff made notifications to external bodies as needed. For example, statutory notifications to the Care Quality Comission, safeguarding and the Health and Safety Executive.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. These were available in a patients spoken language when required.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress. We saw carers being updated by telephone calls or in person for several patients. Patients could request staff to contact their relatives on the phone to speak with them.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

Patients knew how to complain or raise concerns and received feedback when doing so. We viewed 3 complaints. One safeguarding referral was made after a patient complained about the care they had received. This was processed and investigated appropriately and the patient and their relative given timely feedback. For example staff met with the patient and relative and explained their findings.

Staff protected patients who raised concerns or complaints from discrimination and harassment. Staff ensured patients were treated fairly and dealt with complaints confidentially.

Staff knew how to handle complaints appropriately. Staff knew about informal and formal complaints processes and how to escalate concerns.

Staff received feedback on the outcome of investigation of complaints and acted on the findings. There was an active You Said We Did board and one change was made each month on each ward in response to any issues raised.

There was also a topic of the month for all staff which focused on any recent learning from incidents or complaints.

We make sure that everyone can access the care, support and treatment they need when they need it.

Managers monitored waiting times and made sure patients could access services when needed and received treatment within agreed timeframes and national targets.

Managers and staff worked to make sure patients did not stay longer than they needed to. Staff started discharge planning with the patient and relatives shortly after admission.

The service moved patients only when there was a clear medical reason or in their best interest.

Managers monitored that patient moves between ward/services were kept to a minimum. This was important to ensure patients did not become confused or disorientated.

Staff planned patients’ discharge carefully, particularly for those with complex mental health and social care needs.

Staff supported patients when they were referred or transferred between services.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the patients individual views and wishes were respected and valued.

Staff were trained in equality, diversity, inclusion and human rights. There was a diverse workforce and the rights and needs of all patients and staff were recognised.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Staff support patients to make decisions about their care and treatment and their future – for example do not attempt cardiopulmonary resuscitation (DNACPR) forms.

Staff create personalised care plans to account for the patient’s needs, wishes and feelings. These care plans were audited monthly and reviewed on a regular basis.

Care for people who are nearing the end of their life is managed and communicated in a sensitive and dignified way. We saw an example of good practice in documentation developed for the end of life pathway. The document was comprehensive and holistic. However, this had not been fully completed by staff on the ward and had not been put into practice.

Staff ensure all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. Specialist practitioners including tissue viability nurses and a safeguarding lead were available on the ward.