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This service was previously managed by a different provider - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 16 October 2019

Our rating of services improved. We rated it them as good because:

  • We inspected medical care and rated the service as good which was an improvement from previous ratings. The rating for safe, effective and responsive improved to good. The rating for good stayed the same. The rating for well led stayed the same as requires improvement.
  • We inspected surgical services and rated the service as good which was the same as previous ratings. The ratings for safe improved to good. The ratings for effective, caring, responsive and well led stayed the same as good.
  • We inspected outpatient services and rated the service as requires improvement. We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings. The ratings for caring was good. The ratings for safe, responsive and well led were requires improvement. The effective domain is not rated.
Inspection areas

Safe

Good

Updated 16 October 2019

Effective

Good

Updated 16 October 2019

Caring

Good

Updated 16 October 2019

Responsive

Good

Updated 16 October 2019

Well-led

Requires improvement

Updated 16 October 2019

Checks on specific services

Medical care (including older people’s care)

Good

Updated 16 October 2019

Our rating of this service improved. We rated it as good because:

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
  • The service-controlled infection risk well. Staff used infection control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
  • The service had enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix and gave bank staff a full induction.
  • Staff gave patients enough food and drink to meet their needs and improve their health. The service could made adjustments for patients’ religious, cultural and other needs. Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held meetings with them to provide support and development. Staff had a good understanding of consent, mental capacity and deprivation of liberty safeguards.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff provided emotional support to patients, families and carers to minimise their distress. They understood patients’ personal, cultural and religious needs.
  • The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care.
  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.
  • Staff were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work. The service had an open culture where patients, their families and staff could raise concerns without fear.

However:

  • Patients’ records of their care and treatment were not always completed in line with professional record keeping standards or trust policy.
  • Staff reported delays in the delivery of some equipment and safety equipment was not always replaced when broken.
  • The ward did not have a tool for assessing patients’ pain where their communication may be impaired, for example for patients who were confused or suffering with dementia. This was an action in the dementia strategy but had not been carried out yet.
  • Staff did not always assess patients’ mental capacity to make informed decisions about their care and treatment in a timely way and these assessments were not always documented in the patients’ notes.
  • Leaders and teams used systems to manage performance however the new care group performance dashboards were still under development. Senior managers were aware of service risks, but we were not assured local risks were recorded or acted upon. The trust had plans to cope with unexpected events.
  • Leaders operated within new governance processes. Staff had recently been appointed at all senior management levels and clarity about their roles and accountabilities was still developing.

Surgery

Updated 16 October 2019

See guidance note AL4 then add your text after the standard text paragraph below (and delete this help text).

Our rating of this service CHOOSE A PHRASE. We rated it it as CHOOSE A RATING because:

Outpatients

Updated 16 October 2019

See guidance note AL4 then add your text after the standard text paragraph below (and delete this help text).

Our rating of this service CHOOSE A PHRASE. We rated it it as CHOOSE A RATING because: