14 January to 5 February 2020
During a routine inspection
- We rated responsive as outstanding. We rated safe, effective, caring and well led as good.
- In outpatients people could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with national standards. The referral to treatment indicators were a positive outlier and were better than the England overall performance. The service was inclusive and took account of patients’ individual needs and preferences. It was easy for people to give feedback and raise concerns about care received.
- The service had enough nursing and medical staff during the day with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. A business case had been submitted to increase the out of hours nursing support. Staff knew how to apply training and understood how to protect patients from abuse. All areas were visibly clean and tidy and clinical waste was managed well. Staff kept detailed records of patients’ care and treatment. The service safely prescribed, administered, recorded and stored medicines. The service managed patient safety incidents well.
- The service provided care and treatment based on national guidance and evidence-based practice. Staff told us they assessed patients to see if they were in pain and gave pain relief in a timely way. Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. Staff supported patients to make informed decisions about their care and treatment.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff provided emotional support to patients and relatives. They understood patient's personal, cultural and religious needs. Staff supported and involved patients, families and carers to understand their condition and make decisions.
- The service had a clear leadership structure and staff told us leaders were approachable, supportive, well respected and visible. We found the department had a culture of openness and inclusivity. Staff we spoke with felt they were valued and respected by colleagues and senior staff. There were established governance arrangements and regular meetings within the department, which fed into directorate and trust governance. Risks and incidents were well managed and escalated appropriately.