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Royal Cornwall Hospital Requires improvement

All reports

Inspection report

Date of Inspection: 25 January and 25 May 2011
Date of Publication: 29 June 2011
Inspection Report published 29 June 2011 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

Our judgement

The safety of patients is sometimes put at risk due to reduced staffing levels and skill mix that could be improved.

User experience

We were told by nurses and consultants that there is a stable team of staff in the operating theatres with low turnover and virtually the same staff ‘week on week’ which makes for ‘a very safe situation’. Four staff told us staffing had been ‘an issue’ in recent months. Staff said a shortage of well trained skilled staff was often an issue.

We were told that the departments sometimes have to use bank nursing and support staff specifically employed to work across all Royal Cornwall Hospitals Trust sites) staff and that although they are often experienced in the particular departments this is not always the case and then it puts extra pressure on the regular staff within the unit.

We saw medical students and student nurses present during some cases we observed. Staff said they enjoyed having students but found that they could not always offer as much time to them when they were short of staff.

One operation was being carried out by a registrar grade surgeon. The assistant was also acting as a scrub nurse. We were told this was acceptable practice for the routine procedure being carried out. A more senior grade surgeon was available within the department. However, this theatre was short of an extra member of staff to compensate for this.

Staff said, despite re grading of some nursing staff going on, normally morale and team work was very good within the theatres. Staff said they felt part of a team and could move between theatres with maintaining particular interest in specific types of surgery. For example one member of staff said they felt confident to work within all trauma theatres but was used for specialist hand surgery.

Senior staff indicated that staff numbers were correct but there was an issue about staff rostering and skill mix. We were told that interviews for theatre staff were taking place on the day of the inspection visit.

We saw one of the theatre managers answering the telephone frequently. Some of these calls did not need an experienced practitioner to answer them. They took her away from other jobs that were more relevant to her role. We saw support staff standing around waiting for patients to arrive in the department.

The paediatric dental day case unit was very well set up for children with a very stable group of clinicians who behaved very professionally in a paediatric environment.

Other evidence