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We are carrying out a review of quality at Chesterfield Royal Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 17 May 2011
Date of Publication: 12 July 2011
Inspection Report published 12 July 2011 PDF | 155.41 KB

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People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 17/05/2011, checked the provider's records, observed how people were being cared for, looked at records of people who use services, talked to staff and talked to people who use services.

Our judgement

People’s needs are met, but their care plans and assessments do not always have sufficient detail to ensure that people receive appropriate care and treatment with a personalised approach.

User experience

Most people told us they had been involved in the assessment of their needs, both in the outpatients clinics and on admission to the wards. People told us that staff explained the plan of treatment and they had the opportunity to ask questions. One person told us they had not been involved in any aspect of planning their care. Not all of the care plans we looked at had been signed by the person, or their representative. This is good practice to confirm the person’s involvement in planning their care.

Some people told us they had looked at their care records though most people said they had not. One person told us they thought they would not understand the care records and said the nurses explained everything anyway. One person said they had not been told whether or not they could look at their care records. We saw a sign on each bed indicating that the care records were for staff attention only. This may deter people from looking at their records or from asking staff to explain their records.

People we spoke with were generally happy with the care and support they received. They told us “I’ve been well looked after”, and said the staff were “so kind” “they do everything willingly and cheerfully”. One person told us they appreciated the helpfulness and straightforward approach of the stoma nurse so the person now knew how to manage their stoma care independently.

Three people on one ward we visited expressed concern that there was very little on the ward to occupy their time. Several people told us they did not use their bedside television as this was expensive.

In the surveys and other information we looked at people said they usually received appropriate care to meet their needs.

Across the wards we visited, we found that people’s care plans were not completed to a consistent standard. The assessments and care plans we saw were based around the activities of daily living and were pre-printed standard plans that could be individualised according to the person’s needs. On one ward the activities of daily living assessment for one person provided a detailed picture of their needs and the level of support they required, including their personal preferences on how this was to be given. Another person on the same ward who was more independent had limited information as most areas of the assessment had not been completed. In the birth centre at Chesterfield Royal Hospital there were detailed assessments for women, and their records demonstrated that the care and treatment throughout their pregnancy was monitored to ensure individualised care was provided.

On one ward we saw that information added by staff to the care plans we reviewed was very brief and did not reflect the person’s individual needs and preferences. For example, for one person who had a catheter in place, staff had simply added the word ‘catheter’ to the standard care plan with no details of the person’s preferences for how the catheter should be managed.

We found that care plans did not always have sufficient details of the person’s needs. One example of this was a person who told us they had been on the ward since the end of February and had recently had a shower and their hair washed for the first time. We saw that this person’s care records did not have sufficient details about their personal hygiene needs. The care plan stated that the person required a bed bath and the care records said the person had received a bed bath but did not give the reason for this. There was no reference to the person receiving or being offered a regular shower or bath. Another example was a person who did not have an assessment or care plan about their risk of falling, despite their assessment on admission noting a left-sided weakness and difficulty in standing. Another person had large areas of bruising to their arms and a large dried ulcerated area to their leg. The person said they did not know what had caused the bruising. Their care records stated that the ulcerated area to the

Other evidence

We found that the nursing notes, written at least once a day for each person, were more detailed and up to date than the care plans. Staff we spoke with said they had details of the person’s current needs through reading the nursing notes and through written and verbal information received at each shift handover.