Poole 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Review of patient care plans showed their needs were assessed using nationally recognised tools. We saw staff reviewed care plans on a daily basis to ensure they still met the needs of patients. Discussion with patients indicated their conditions and needs had been discussed with them and their views about how to best meet their needs taken into consideration.

However, despite requesting care plan audits, no audits were provided. The trust described documents including care plans, were reviewed through the patient safety incident response framework process. And through the matron walkabout process. However, there was no evidence that the service had assurance that staff fully assessed patients’ needs using the care planning process.

The service planned and delivered people'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.

Staff had access to policies and procedures that were in line with national guidance. The sample of policies and procedures provided by the service demonstrated they were kept under review and referenced relevant national guidance and practice.

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Staff acted to ensure risks for patients relating to surgical procedures were reduced by following best practice guidance. Staff followed best practice guidance for safe perioperative care from the Association for Perioperative Practice (AfPP 2022) for the setting up of and checking of instruments. Staff followed the WHO Five Safer Steps to Surgery process. The National Hip Data Base showed there were improvements in the number of patients who had surgery supervised by both a consultant anaesthetist and a consultant surgeon.

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However, there was an example where best practice guidance was not being used to support effective staffing. The perioperative care collaborative position about dual roles detailed staff could dual role for minor procedures if this was supported by a policy. Staff were not aware of this and said they could not dual role for dental extractions which are classed as minor surgery.

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The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Throughout the inspection we saw multidisciplinary team working in all areas. Clinical staff said nurses, doctors and allied health professionals worked well together within medicine and felt part of the team. There were regular multidisciplinary meetings during the day where doctors, nurses, discharge coordinators and allied health professionals discussed patient care, ongoing treatment, and discharge plans.

Staff referred patients with acute mental health conditions to the psychiatric liaison service which was provided by another NHS trust. Staff said the psychiatric liaison team was responsive and available to support patients with mental ill health and their treatment plans.

The trust was introducing an electronic patient record across all services, including surgical services, so patient records could be accessed by teams working across the hospital. The service used the trust's recently introduced assessment and discharge document. This meant the assessment of patient's needs was shared when patients moved between different services in the hospital. All members of the team caring for patients could input into the form from admission through to discharge, so all aspects of patients' care needs were included.

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Discharge policies and processes gave staff guidance to ensure relevant patient information was shared with external providers, including GPs and other care providers. However, CQC had received some information from external sources, including patient relatives and adult social care service, about poor discharge information.

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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, reduce their future needs for care and support.

The service had some processes in place to support people manage their health to be in the best condition for planned surgery. Preoperative assessment processes screened patients for conditions such as diabetes, smoking, frailty, blood pressure, anaemia, obesity, and obstructive sleep apnoea. There were referral pathways for diabetes, anaemia, and obstructive sleep apnoea. Patients who had high blood pressure were routinely signposted to their GPs for treatment and monitoring. There was access to the trust frailty service and patients who smoked or had obesity were signposted to a local external community service for support and advice.

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Assessment processes on admission included assessment of alcohol intake, smoking, and if needed referrals to relevant support /advisory services were made.

The services did not have a prehabilitation programme, which would support patients to be at their optimum healthiest for surgery. However, this was in the process of being developed collaboratively with external partners.

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For patients who had limb amputations, the prosthetic service provided a holistic approach to supporting people to live health and independent lives after amputation.

Patient information leaflets, some available on the trust website, gave patients information about general recovery form surgery and recovery specific to the type of surgery they had undergone. We observed patients had information leaflets and discussion with patients showed they understood guidance in information leaflets.

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The service routinely monitored people’s care and treatment to continuously improve it. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service participated in relevant national clinical audits. Outcomes for people were mainly positive and mostly met expectations.

Performance in the National Bowel cancer audit results for 2023 showed a 9.2% 2 year mortality rate for patients undergoing surgery for bowel cancer and a 90 day survival rate of 96.1%.

Performance in the National Prostate cancer audit for 2024 showed 11.7% of patient had genitourinary complications within 2 years of surgery. This was slightly above the national average.

The service also used a system called Patient Reported Outcome Measures (PROMs). This is where patients who had hip or knee replacements were asked how they felt after their surgery. This information was analysed and published by NHS England. NHS England is the national body that leads the NHS in England.

The National Hip Fracture Data Base showed there had been improvements made in the fractured neck of femur service. For example, there were reducing numbers of patients who acquired a pressure ulcer and since September 2024 the service had performed better than the national average for hours from admission to operation. Data provided by the service showed that in January 2025 74% of patients with a fractured neck of femur had their operation with 36 hours of admission. This was above the national average of 59% and was an improvement since the last inspection in 2022. However, the trust set a target of 95% of fractured neck of femur patients to be operated on with 36 hours of being medically fit for surgery. In December 2024, 87% of patients received their surgery within 36 hours of being fit for surgery, with 62% of patients receiving surgery within 36 hours of admission.

However, in theatres although there were audits for the insertion of intravenous lines catheter insertion and WHO Five Safer Steps to Surgery process, there was limited audit to give assurance on the standards of staff practice.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gained consent from patients for their care and treatment in line with legislation and guidance. Staff made sure patients consented to treatment based on all the information available. Staff clearly recorded consent in the patients' records.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff could clearly describe the correct process for establishing the capacity of patients to make decisions about their care.

Staff understood the use of Deprivation of Liberty Safeguards. Discussion with staff demonstrated they had a good understanding about the use of Deprivation of Liberty Safeguards, and when and how they should apply for a Deprivation of Liberty Safeguard for a patient.

Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act, and they knew who to contact for advice.

Patients confirmed in conversations staff had provided them with information to enable them to understand and make an informed decision about consenting to surgery.

Staff had access to a consent policy. The policy was kept under review by the Trust and referenced relevant legalisation and national guidance. There was clear guidance for staff about when and how to obtain consent, how to manage consent with for a patient who lacked capacity to give informed consent about a specific decision. The policy also gave instruction about what training staff needed to complete about consent.

The trust had a Mental Capacity Act Policy that was kept under review by the Trust, (review date January 2027). There was guidance for staff about when and how to apply the mental capacity act and all staff were required to complete training about the mental capacity act.

The trust provided a sample of audits to demonstrate monitoring of compliance with the consent process. These included, where required, action plans to support improvements in the consent process. However, the audits were specific to consent for specific interventions. There was no evidence of audit or monitoring of the consent process to give a service wide view of compliance with consent.