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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 coordinated care when they move between different services (outcome 6)

Meeting this standard

We checked that people who use this service

  • Receive safe and coordinated care, treatment and support where more than one provider is involved, or they are moved between services.

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’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

Reasons for our judgement

We visited Ward 2 and asked senior staff about arrangements for discharge planning. We were told that this process started on admission where assessments were made of a patient’s circumstances, how long they were likely to stay hospital and how well they might be on leaving.

We were told there was a named discharge co-ordinator and we took the opportunity to speak to them. This member of staff described the role of the Integrated Discharge Team which is a group of professionals from the hospital and social services co-located at Leighton Hospital who work together to support the discharge of patients. They told us how the process worked and made reference to The Trust’s discharge protocols and procedures.

When we spoke to patients on Ward 2 we asked them whether staff had discussed arrangements for going home with them. One patient told us they didn’t know a date to go home as it was some way away but that “the physio and me are working together” and that the arrangements for the support that would be needed at home had been discussed. They said the consultant had involved their relative in the discussion. Another patient told us their discharge was dependent on the work they did with the physiotherapist. They said they had had assessments for tasks of daily living such as washing and dressing (which would have been done by social services staff) and that their spouse was also involved in discussions.

On Ward 21b we spoke to patients about how they were involved in any planning for them to go home. One gentleman said the staff were planning for him to go home but that he needed support for this and they were arranging for a “type of home help”.

We looked at the notes for a sample of patients on the ward and saw good examples of discharge planning. In one file there were discharge checklists which demonstrated co-operation with other providers through communication with and input from social workers. There was also evidence of referral to community staff who work for a separate NHS trust such as a community matron and continence advisor.

For a second patient there was again a discharge checklist and there was evidence that discharge planning had started on the day of admission and continued with input from a multi disciplinary team. There were communication sheets showing that relatives of the patient had been involved in the planning.

In the documentation of another patient who was ready to go home that day we saw the notes demonstrated the arrangement of out-patient appointments, an assessment by social services of their home and plans for support by a community dietician. There was documented involvement by an occupational therapist and transport arrangements for them to get home had been arranged with an ambulance service.

We asked that The Trust send us copies of the discharge polices and procedures that staff had referred to during our inspection visit. We saw that this confirmed what we were told in our conversations with ward staff and that there was a Joint Discharge Policy that had been developed in conjunction with Cheshire East and Cheshire West and Chester councils. There were also policies for groups of patients with a need to be supported by a specific service outside of The Trust, for example Macmillan Nurses.