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Other CQC inspections of services

Community & mental health inspection reports for Alderney Hospital can be found at Dorset Healthcare University NHS Foundation Trust.

Inspection carried out on 5, 8 April 2013

During an inspection looking at part of the service

Our inspection visit took place over two days. On the first day we spoke with patients, staff and observed routines on the hospital�s two physical rehabilitation wards. This was in order to find out about people�s experiences of the care they received.

On the second day we spoke with patients, visiting relatives, staff and observed routines on two assessment and treatment wards for older people with mental health problems. This part of our inspection took place on a different hospital site. This was because patients and staff had been transferred there due to refurbishment of wards at The Alderney Hospital.

People we spoke to or their relatives told us they had been involved in decisions about their care and treatment. They said they were treated with respect and their dignity was upheld.

Where people lacked capacity to consent to their treatment there were proper procedures in place that ensured decisions made on their behalf were in their best interests.

People told us they received the help and support they required. We saw documents showed that people�s needs had been identified and plans put in place that ensured their welfare was promoted and their needs were met.

There were arrangements in place that ensured people received nutritious food and were protected from the risk of dehydration.

There were arrangements in place that ensured records were accurate and up to date.

You can see our judgements on the front page of this report.

Inspection carried out on 31 August 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to be a patient at the Alderney Hospital. They described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality of food and drink available. This was because the inspection was part of a themed inspection programme to assess whether older people in hospitals were treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector who was joined by a practising professional and an Expert by Experience who has personal experience of using or caring for someone who uses this type of service. We talked with patients and observed the care and support provided to others. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We visited one assessment and treatment ward for 29 people with dementia. Patients on this ward were not able to tell us about their experience of receiving care at the Alderney Hospital. Therefore, we relied on our observations and our discussion with staff on the ward to inform our judgements on this occasion. We also visited two rehabilitation wards which had beds for 48 patients. We talked with eight patients on these wards whose views are reflected below.

People on the rehabilitation wards told us they were treated with dignity and respect. For example, one patient reported that staff always knocked on their door before entering. Another patient told us that staff called them by their preferred name. However, one patient commented that a member of night staff had displayed annoyance when they had drawn their attention to a patient who was calling for assistance. They said that the member of night staff had told them not to interfere. They told us that this had made them feel frightened to call for help at night. Patients reported that staff were mindful of promoting their dignity when helping them with their personal care by closing the door and drawing curtains to ensure their privacy was maintained.

Patients on the rehabilitation wards reported that staff talked with them about their care. One patient commented, "They come and ask...they explain things." Another patient told us that they had wanted to sleep in their chair at night as this was what they did at home. They told us that staff had explained the risks to them and had respected their choice.

Patients told us that they had not always seen their care plans but would like to be given the opportunity.

Patients on the rehabilitation wards told us that they had a choice of two meals at lunch time. One patient commented, "I don't like pork. If that's on the menu there is always something else. I have been in other hospitals but have never been in one where the food was so good." Patients told us that they were given enough to eat and drinks were available during the day and evening. They told us that staff assisted them to eat when they required help. A patient who had diabetes confirmed that they were given suitable food to meet their needs.

We talked with five patients on the rehabilitation wards about whether they knew how to raise concerns about their care. Three patients told us that they had not been informed about how to raise concerns and had not heard of the hospital's Patient Advice and Liaison Service (PALS). One patient we spoke with told us, "I feel safe here. Staff are not abusive. They are so kind. There is a safe where valuables can be locked away." Another patient commented that staff always maintained a professional attitude even in challenging situations.

We spoke with eight patients on the rehabilitation wards about staffing. They told us that there were generally enough staff available to meet their needs. For example, one patient said, "If I get tired they will help me get back to bed. The longest I have had to wait is 15 minutes." Another patient commented, "I say there are enough staff. They come reasonably quickly if I use the buzzer."

Patients told us that staff understood their needs and they felt safe receiving care. One patient commented that there was a high use of agency staff and they also received care from student nurses. The patient told us that both agency staff and student nurses were good at their jobs and were given information about their needs so they could give them appropriate support.

Inspection carried out on 19 August 2011

During a routine inspection

We spoke to six patients on the two rehabilitation wards, Jersey and Guernsey. We also spoke to five patients on the two wards that provided assessment and treatment for older people with mental health problems, Herm and St Brelades. We also spoke to six visiting relatives and friends as well as fourteen nursing and other clinical staff.

Some patients were not able to tell us of their experiences of the care and support they received because of their mental frailty. Consequently we observed groups of individuals, particularly those in the Haymoor day unit. We were able to assess the experiences of patients who were unable to communicate with us by observing the quality of the interactions that took place with hospital staff as well as the demeanour and actions of both patients and hospital staff.

Patients who were able to talk to us told us that hospital staff were �good�, �very nice�, �super�, and �wonderful�. They told us that the staff were �polite and respectful� and ensured that their dignity, privacy and choices were promoted. They said they were well looked after and that they felt safe. They also told us that the staff made sure they received medication when they needed it. They also said the food they received was good. They said that staff were �well trained�, �highly efficient� and �competent. Some people were able to tell us that they were involved in and consulted about the care they received.