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Luton and Dunstable Hospital Good

All reports

Inspection report

Date of Publication: 13 July 2011
Inspection Report published 13 July 2011 PDF

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

Our judgement

The CQC had minor concerns in relation to this outcome area.

There had been a high level of improvement activity within the Trust. This had included further training for all staff in relation to safeguarding and the Mental Capacity Act, and the introduction of a new and more structured system for staff supervision and appraisals. The Trust had commenced a process of evaluating the impact of this activity, and early indications suggested that there had been a positive impact on staff. However there was further work to be undertaken in order for the Trust to achieve full compliance with this essential standard.

User experience

We did not speak with people who use this service as part of this review.

Other evidence

When we visited this service in February 2011, many staff that we spoke with told us that they had not had the opportunity to meet with their managers for 1:1 supervision. Some staff also said that they had not had an appraisal carried out to identify their personal development and training needs.

Updates on improvement actions undertaken by the Trust had told us that Ward Managers were holding daily ‘safety briefings’ with their staff, and that on a weekly basis these managers invited feedback from staff and offered one to one sessions that were documented.

Quarterly 1:1 reviews with all staff had been introduced and this was in addition to their annual appraisal. Each ward staff member trust wide, now had a date pre set for their next appraisal and an action and development plan in place.

Spot checks were taking place on wards to assess the effectiveness of these forums. These involved staff being asked 5 questions including one about their last 1:1 meeting. These spot checks were being carried out by the Director of Nursing.

Data regarding staff supervisions and appraisals was collated and monitored monthly from each ward and department. This had enabled management to identify how many staff had had a supervision or appraisal carried out each month and to identify where there were gaps in this process.

Since our last review in February 2011, further training in safeguarding had been introduced for all staff. By the end of May 2011, 86% of all staff had undergone this training, and all those that had not, had been identified and booked on training for 15 June 2011. More specific training in the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) had also been introduced with assistance from Luton Borough Council safeguarding and MCA leads.

There had been a high level of improvement activity undertaken in relation to the systems and processes in place to support staff and to ensure they were helped to successfully fulfil their roles. The Trust told us that an audit of staff competency and knowledge in relation to safeguarding had been carried by an external reviewer. This had involved questioning a selection of ward based staff at random to assess the impact of the recent training on their knowledge.

Early indications from this audit identified that the staff's basic awareness of safeguarding had improved since our last review in February 2011. However it highlighted an ongoing challenge for the Trust to ensure that all staff fully understand how the Mental Capacity Act and patient's consent is linked to safeguarding processes.