Scarborough Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained Requires Improvement. This meant people’s needs were not always met.

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We saw that there was there were delays in the completion of risk assessments and that the service was not able to consistently ensure that all patients could access the care they needed in a timely manner.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed an inconsistent standard. The service did not always demonstrate that people were at the centre of their care and treatment choices,

We saw an inconsistent approach to the completion of risk assessments. We saw staff completing appropriate risk assessments and documenting appropriately but when we reviewed 10 previously completed patient notes, we saw omissions or errors in 7.

We found an inconsistent approach to the recording within patient notes. We saw examples of care plans that lacked evidence of patient input or personalised goals and incomplete or generic records that did not reflect changing needs or preferences.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

All staff could articulate how their local communities had diverse health and care needs. All staff could give examples of patients who had varying levels of need and could describe how they would accommodate them. This included patients with chronic and long-standing conditions that required a different approach.

The evidence showed an inconsistent standard. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain but information was only in English and was not available in alternative formats or languages.

The information provided was not always in a form accessible to the patient groups such as easy-read or braille.

We saw examples of staff ensuring carers and families were regularly updated about the patient’s progress.

We saw computers unlocked when not in use and examples of paper records with patient information being left in plain sight which did not provide assurance that confidential information was kept secure.

All staff were able to describe how they made notifications to external bodies, such as the local authority for safeguarding issues and to the UK Health Security Agency for notifiable illnesses.

We saw examples of discharge summaries which included advice given to patients on discharge on how to manage their condition and safety netting of when to seek further advice whether returning to department or seeking GP input. We also noted clinicians completing information to inform patients’ GPs of changes to medication.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

We reviewed 5 complaints received prior to inspection and saw that all were managed in line with trust policy. We also saw that themes were identified and actions created to address them.

All patients were given the opportunity by staff to give feedback, and staff would assist any patient to make a complaint or raise a concern.

We saw examples of feedback provided to patients who had complained or raised concerns.

Feedback was actively encouraged, and equal importance was given to both good and negative feedback as it was an opportunity to learn and to improve. We saw that issues with the hearing loop would affect patients with hearing loss providing feedback, we saw that the issue had been urgently escalated.

Staff were able to articulate the process and their role in how to handle complaints appropriately.

Staff received feedback on the outcome of investigation of complaints and acted on the findings. Any learning from complaints was discussed during safety huddles and was also disseminated by email to ensure all staff had access.

The evidence failed to show a good standard. The service was unable to ensure that people could access the care, support and treatment they needed when they needed it or within agreed timeframes and national standards. The service was previously in breach of the legal regulation in relation to access. Improvements were not found at this assessment, and the service remained in breach of this regulation.

The percentage of patients admitted, transferred or discharged within 4 hours of arrival at the trust was 62%, which was worse than the England average.

In the 12 months prior to inspection, an average of 371 patients per month waited more than 4 hours but less than 12 hours from decision to admit to ward admission. Monthly figures ranged from 193 to 429 patients. We requested more specific information from the trust, but none were provided.

In the 12 months prior to inspection, an average of 184 patients per month waited over 12 hours from decision to admit to ward admission. This equated to 15% of patients, which was worse than the national average of 10%.

Only 78% of patients presenting in an urgent mental health crisis were seen by the appropriate specialists within 4 hours.

In the 12 months preceding inspection, all walk in patients received an initial assessment within 2 minutes. We observed initial assessment during inspection and the time taken was not sufficient to complete an accurate assessment and did not provide assurance that this was effective.

Ambulance handovers were not consistently completed within the required timeframes due to high patient demand and limited patient flow through the department. We saw that 40% of patients were handed over within the NHS national standard of 15 minutes, compared with the national average of 65%. We observed patients who had not been formally handed over to hospital staff, meaning staff were not aware of their presenting conditions. This limited timely and accurate assessment and delayed access to appropriate care.

We saw that 87% of patients presenting with a mental health issue were seen within 60 minutes.

We did note that 5% of patients left the department without being seen, which was the same as the national average.

The unplanned reattendance rate was 8%, which was better than the national average of 9%.

Patients were able to receive investigations such as x-rays and scans in a timely manner.

Evidence from the past 12 months showed ongoing shortfalls in this area. The provider did not make sure that people could consistently access the care, support and treatment they needed when they needed it.

The NHS 2024 Staff Survey results had highlighted multiple areas of concern with no staff responses showing improvement and all scores below average and worse than the previous staff survey results.

We did note plans were in place to address the issues highlighted but this was not fully embedded at the time of inspection.

All staff had the opportunity to undertake training in equality, diversity, inclusion and human rights. Training compliance provided demonstrated that all staff had completed the required training.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

We saw examples of staff supporting patients to make decisions about their care and treatment and their future. We saw the use of treatment escalation plans which were completed with patients.

Staff were able to articulate how they would care for people who were nearing the end of their life and how they would ensure that it was managed and communicated in a sensitive and dignified way. We saw that the trust had introduced a designated area for patients at the end of life which had increased privacy for the patient and their family.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. We observed patients being referred to appropriate specialities.