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Stamford & Rutland Hospital Good

Inspection Summary


Overall summary & rating

Good

Updated 20 December 2019

A summary of this hospital appears in the overall summary above.

Inspection areas

Safe

Good

Updated 20 December 2019

Effective

Requires improvement

Updated 20 December 2019

Caring

Good

Updated 20 December 2019

Responsive

Good

Updated 20 December 2019

Well-led

Good

Updated 20 December 2019

Checks on specific services

Medical care (including older people’s care)

Good

Updated 20 December 2019

Our rating of this service stayed the same. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Surgery

Good

Updated 20 December 2019

Our rating of this service stayed the same. We rated it as good because:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed that training. Staff provided care, in a safe environment and understood how to protect patients from harm. Patients were protected 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.
  • Patients were seen to be treated with compassion and staff respected their privacy and dignity. Patient feedback was positive about all staff that delivered patient focused care.
  • Staff were able to raise concerns, report near misses and report incidents although all staff agreed that they continued to learn from incident feedback.
  • Managers and staff demonstrated commitment to best practice performance and risk management. All staff were committed to continually improving the service.
  • The service controlled infection risk well. The service used systems to identify and prevent surgical site infections. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.
  • Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration
  • 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 and agency staff a full induction.
  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.

Urgent and emergency services

Requires improvement

Updated 20 December 2019

Our rating of this service went down. We rated it as requires improvement because:

  • Not all staff were compliant with mandatory training in key skills, or knowledgeable about appropriate isolation procedures should they treat an infectious patient. Compliance with advanced life support, immediate life support and paediatric immediate life support was low. Staff knowledge of the Mental Health Act 1983, Mental Capacity Act 2005 and Deprivation of Liberty Safeguards was inconsistent. Opportunities for wider learning from incidents were not always considered.
  • The design and use of the waiting area did not meet national guidance. No formal environmental risk assessment had been undertaken to ensure all reasonable steps to mitigate risk had been undertaken.
  • There was a lack of clarity in leadership at a local level. Governance, risk and quality performance processes were not embedded or aligned across the division, with the majority of focus given to Peterborough City hospital. Local audit was not utilised to monitor and improve services.
  • There was a lack of formalised minutes for team, training and clinical business unit meetings. This meant the potential risk that concerns may not be addressed or actions identified completed and opportunities to improve the service could be missed. We were not assured of the frequency of meetings or attendance and representation from staff at Stamford and Rutland hospital.
  • We raised concern over an individual member of staff in relation to their manner, conduct and awareness of consent when providing direct patient care. We were assured by the matron that the concerns would be looked into and where appropriate support, training and supervision would be provided.

However, we also found that:

  • The service had enough nursing staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff followed infection control principles including the use of personal protective equipment. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to drink, and gave them pain relief when they needed it. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.

Outpatients

Good

Updated 20 December 2019

We previously inspected outpatients jointly with diagnostic imaging in 2014, so we cannot compare our new ratings directly with previous ratings.

We rated it as good because:

  • The outpatients service had enough staff, provided mandatory training and made sure everyone completed it. Staff understood how to protect patients from abuse. The service controlled infection risk well. The service managed medicines appropriately and ensured that records were stored securely.
  • The service provided care and treatment based on national guidance and evidence-based practice. Staff gave patients enough food and drink to meet their needs. Staff assessed and monitored patients regularly to see if they were in pain. Staff monitored the effectiveness of care and treatment. The service made sure staff were competent for their roles. Managers appraised staff’s work performance and staff worked together as a team. Staff supported patients to make informed decisions about their care and treatment.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
  • The service planned and provided care in a way that met the needs of local people and the communities served. The service was inclusive and took account of patients’ individual needs and preferences. People could access the service when they needed it and received the right care promptly. It was easy for people to give feedback and raise concerns about care received.
  • Leaders had the skills to run the service, and staff felt respected, supported and valued. The service used systems to manage performance effectively, collected reliable data and analysed it. Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services.