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Inspection report

Date of Inspection: 5 December 2012
Date of Publication: 31 January 2013
Inspection Report published 31 January 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We reviewed all the information we have gathered about Leighton Hospital, looked at the personal care or treatment records of people who use the service, reviewed information sent to us by the provider and carried out a visit on 5 December 2012. We observed how people were being cared for, talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

When we carried out our unannounced inspection we visited Ward 2 and spoke to staff about the arrangements for the assessment and planning for people’s care when they first arrived on the ward. It was explained that assessment was done as soon as possible after patients arrived and in any case within 24 hours. We also understood that assessments done as part of emergency admissions in other parts of the hospital would be repeated on arrival on the ward. Reassessments were done either as required or to a schedule. For example everyone was weighed at least once a week and pressure area assessments to protect people from the risk of bed sores were done every day. If someone had a fall then other assessments such as mobility and falls risk would be redone.

Because of previous concerns about the development of pressure sores in the hospital we asked for more information about this aspect of care and it was clear that staff were familiar with the Trust’s Pressure Ulcer Pathway, how to assess pressure score risk using a method known as the “Waterlow Scale” and when and how to get advice from tissue viability specialists. We were told that tissue viability support was available over the telephone as well as through visits and we saw that there was a named tissue viability link nurse who attended meetings and cascaded information to other ward staff.

We spoke to four patients on Ward 2 and all were complimentary about the care that they were receiving. One person said “Service is good, nurses are good and they can’t do enough for you. They keep checking to make sure you are alright”. Another said “these professionals are a credit to their profession, nothing is too much trouble”. A third patient said of the staff, “I feel totally safe. They explain everything to me – they are like angels” and “It’s a wonderful place; they take care of me and care about me”.

Patients on Ward 2 also told us they were treated decently by staff. One said “they are always nice and polite” and another when asked whether they were treated with dignity and respect replied “very much and every time”.

We also visited Ward 21b and again staff told us that risk assessments were done promptly on admission and reassessed as needed or to a schedule. Staff on this ward which looked after older people who were vulnerable to pressure sores were particularly knowledgeable on the subject and were able to speak confidently about what to look out for and what to do if a problem was suspected.

We looked at a sample of patient records on both wards and found that they corroborated what we were told by staff. We saw that risk assessments were completed in a timely fashion following admission and the notes recorded any reassessments that took place. When risks were present these were addressed in care plans and we noted that for pressure sore prevention there were specific care plans that referenced guidelines from the National Institute for Health and Clinical Excellence (NICE).

Patients on Ward 21b were also complimentary about the care they were being given. One person said “Staff are very nice, all lovely really, very kind” and “They are polite and kind and gentle”.

On both the wards we observed care being given and in general this was unhurried and attention was paid to patient’s privacy by, for example, the use of curtains around the bed. We saw patients treated in a respectful and dignified way and staff were working to maintain people’s independence.

When we visited the two wards we looked at how staff assessed their own performance and addressed any shortfall. We were shown how each ward completed a monthly audit of its performance against quality and care indicators and that this information was displayed on notice boards in a public area for patients, visitors and staff to see.

On Ward 21b we looked at recent figures and asked senior ward staff about them. We noticed that in October 2012 there had been a low score for cannula site care, (The cannula is the