New Royal Liverpool University

Updated 22 November 2023

• The hospital had not always ensured that risk assessment for patients, such as falls or pressure ulcers and been completed.

• There had not always been sufficient numbers of staff on wards or suitable qualified staff available in endoscopy to recover patients.

• Controlled substances that were hazardous to health had sometimes been left in unlocked areas, meaning that patients or members of the public could access them. In addition, oxygen cylinders had not always been stored safely, in line with best practice guidance and trust policy.

• Services had not always collected, analysed, managed and used information well to support all its activities. This was because information that was provided before, during and after the inspection had not always been accurate.

• Staff did not always understand how and when to assess whether a patient had capacity to decide about their care. We found that capacity had not always been documented when needed.

• Medication and controlled drugs were not securely stored or prepared in line with trust policy, national guidance and legislation.

• Waiting times in the emergency department had all risen and were greater (longer or more) than the national average.Patients waited for extended periods of time on the corridor to be seen, in some cases more than ten hours.

However:

• The hospital managed infection prevention and control well, the results of infection prevention and control audits were scrutinised and improvements to practice made.

• Services had effective arrangements in place to recognise and respond appropriately to patients

• Staff understood how to protect patients from abuse and the service worked with other agencies to do so. Staff received training in safeguarding.

• Managers across services promoted a positive culture that promoted and valued staff, creating a sense of common purpose based on shared values.

• Staff cared for patients with compassion and that patient’s dignity was maintained on all occasions that we observe

Updated 26 October 2021

Updated 29 July 2016

There were sufficient numbers of suitably skilled nursing and medical staff to care for the patients. We found a culture where incident reporting and learning was embedded and used by staff. There was strong clinical and managerial leadership at unit and divisional level. The unit had a vision and strategy for the coming years developed in accordance with the building of the ‘New Royal’ on the adjacent site. There was an effective governance structure in place which ensured that all risks to the service were captured and discussed. The framework also enabled the dissemination of shared learning and service improvements and a pathway for reporting and escalation to the trust board. Patients and their relatives were cared for in a supportive and sympathetic manner and were treated with dignity and respect. There were issues with access and flow within critical care, which were related to the wider access and flow pressures within the hospital. These regularly resulted in delayed discharges and the associated cancellation of elective surgery.

Updated 29 July 2016

Palliative care was considered integral to the trust and had a well-developed and substantial palliative care directorate which was part of the medicine division. The trust had an embedded strategy for end of life care driven by effective leadership and delivered by committed staff who were highly satisfied with their workplace. Staff frequently went ‘above and beyond’ to deliver compassionate, high quality care that took into account patient’s wishes. The service was complemented by a strong volunteer body who offered respite and emotional support, ensuring no patient died alone. The service was designed with consideration given to the needs of the local population, and the trust adopted a multidisciplinary approach with input from a variety of external stakeholders to ensure joined up continuity of care. End of life care audit data showed the trust performed excellently, scoring above the national average for each of the seven indicators. Staff were competent to perform their roles and received regular training to ensure competence was monitored and maintained. Medicines and other equipment were stored and monitored regularly to ensure patient safety. The service was well staffed, and had 86 link nurses across the trust to educate, advise and support colleagues in end of life care on every ward. Incidents were reported and investigated appropriately by knowledgeable, trained staff and all learning was shared.

Updated 29 July 2016

Policies and procedures were in place for the prevention and control of infection and to keep people safe. Care provided was evidence based and followed national guidance. Staff were competent to perform their roles and worked together in a multi-disciplinary environment to meet patients’ needs. Care that was planned took account of patients’ wishes, and psychological and emotional support was available in a number of outpatient clinics. Patients had a choice of appointments and additional clinics were held in the evenings or at weekends to reduce waiting times. Between May 2015 and February 2016 the trust met the national standard for diagnostic imaging waiting times with the exception of January 2016. Quality and performance were monitored and there was evidence of continuous improvement and innovation.

Updated 26 October 2021

Updated 26 October 2021