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Arrowe Park Hospital Requires improvement

All reports

Inspection report

Date of Inspection: 18, 19 September 2014
Date of Publication: 2 December 2014
Inspection Report published 02 December 2014 PDF

Overview

Inspection carried out on 18, 19 September 2014

During an inspection in response to concerns

We conducted this inspection in response to a number of concerns that were reported to us relating to poor patient care and unsafe discharges. Specific concerns were raised that Ward 1 (surgical day case unit) was being used for patients being transferred from Accident and Emergency (A&E) and related to unsuitable bathing facilities for a mixed sex unit. We raised these concerns with senior hospital management alongside concerns around shortfalls in nutritional action plans for patients and requested an investigation into the care of a patient as a result. We found the system in place for monitoring the care practices for patients was inadequate which puts patients at risk of not having their needs met.

We visited six wards and departments in the hospital, spoke to patients and staff of different grades and reviewed case notes. We observed inconsistencies in the care being delivered in each area we inspected. All the nurses and support workers we observed talked to patients in a kind and professional manner.

We visited the following wards:

Accident and emergency (A & E)

Wards 21 and 22� Care of the Elderly Wards

Ward 1 �Surgical Day Case Unit

Ward 20 � Urology Ward

Ward 33 � Heart Assessment Centre, Cardiology and Renal Ward

On the above wards and departments we spoke with care support workers, staff nurses, ward managers, the deputy associate director of nursing for medicine and the matrons for surgery. In addition we spoke with the director of nursing and midwifery, the associate director of operations for medicines and acute specialties, associate director of operations for surgery and the head of human resources.

We identified some concerns regarding staff providing safe and appropriate care.

We found that the trust needed to take more action to ensure the records made by staff were accurate and promoted the wellbeing and safety of patients because records were incomplete on the care of the elderly wards.

We found the trust had some established quality governance systems in place from ward to board level. We did not have confidence that quality assurance and monitoring processes were sufficiently robust to effectively assess and monitor the quality of service that people received. Areas of ongoing work that required further improvement include the board assurance framework and the risk register.