Musgrove Park Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that children and young people and communities had the best possible outcomes because their needs were assessed. We checked that children and young people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work. 

At our last inspection we rated this key question Good. At this inspection the rating has remained Good. This meant the service made sure children and young people’s care and treatment was effective and outcomes were good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure children and young people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication needs with them. The service used care and treatment plans to improve outcomes for children and young people. Staff were familiar with the pathways and knew how to complete them. Care plans were reviewed and updated regularly in conjunction with the child or young person’s family. Risk assessments were completed when required. 

The service planned and delivered children and young people’s care and treatment with them, including what was important and mattered to them. Staff followed up-to-date policies to plan and deliver high quality care according to evidence-based practice and national guidance. Children and young people’s physical, mental health and social needs were assessed and met. Care, treatment and support, was delivered in line with legislation, standards and evidence-based guidance, including the National Institute for Health and Care Excellence (NICE) and other expert professional bodies, to achieve effective outcomes. The service used policies, care and treatment pathways, clinical protocols and processes. Policies were available to all staff on the intranet system and staff demonstrated they knew how to access them.

The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Doctors, nurses and other healthcare professionals worked together as a team to benefit children, young people and their families. They supported each other to provide good care. We were told “medical staff rush to help each other”.  Staff held regular and effective multidisciplinary meetings to discuss children and young people and improve their care. We were told of an example where 6 consultants in the high dependency unit helped to urgently cannulate a patient during the 7am handover. There were good relationships between the service, outreach and intensive care unit. All necessary staff, including those in different teams, services and organisations, participated in assessing, planning and delivering care and treatment. Staff ensured children and young people received consistent coordinated, person-centred care and support when they moved between different services. There was a close working relationship with other local NHS children’s hospitals. Staff were working together to look at new pathways to streamline and introduce new ways of working to improve patient care. For example, allergy pathways were reduced from 6 and a dietician review had been introduced. Healthcare professionals worked together as a team to benefit children and young people. There were well established links with mental health services. Staff worked across health care disciplines and with other agencies when required to care for children, young people and their families. There was an onsite CAMHS liaison team which provided weekend support and were included in handovers. 

The service supported children and young people to manage their health and well-being to maximise their independence, choice and control. The service supported children and young people to live healthier lives and where possible, reduce their future needs for care and support. Staff gave children and young people practical support and advice to lead healthier lives. Health promotion was a routine part of all care provided to children and young people and their families. Smoking cessation support was offered in the community, and parents could self-refer to the free Somerset service provided by the public health team.

The service routinely monitored children and young people's care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of children and young people themselves. Outcomes for patients were generally positive, consistent and met expectations, such as national standards. Managers and staff used the results to improve patients' outcomes. Managers and staff carried out a comprehensive programme of repeated audits to check improvement over time. Managers shared and made sure staff understood information from the audits.

>

The service participated in relevant national and local clinical audits to review the effectiveness of care and treatment for children and young people. These audits included: Epilepsy 12 National Clinical Audit of Seizures and Epilepsies for Children and Young People where the results demonstrated compliance above the national average. Results for the National Paediatric Diabetes Audit 2022/23 showed the service in a good light for the care process data, however, data for the adjusted mean haemoglobin A1C (HbA1c) blood tests showed a weak performance which indicated a second-round outlier status. This result had been linked to staffing and technology. There was an action plan to address the results with a deep dive into the range of potential factors impacting HbA1c. These results enabled the service to benchmark the standard of care provided against local and national standards. This information was used to improve care and treatment. Action plans were developed to address areas of improvement and were regularly reviewed and reported monthly to the governance meeting.

>

The service told children and young people about their rights around consent and respected these when delivering person-centred care and treatment. Staff supported children, young people and their families to make informed decisions about their care and treatment. They knew how to support children, young people and their families who lacked capacity to make their own decisions or were experiencing mental ill health. Staff gained consent from patients for their care and treatment in line with legislation and guidance. When patients could not give consent, staff made decisions in their best interest, considering patients’ wishes, culture and traditions. Staff made sure patients consented to treatment based on all the information available. Some staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards but training compliance in this area did not meet the trust’s target.