Yeovil District 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 people and communities had the best possible outcomes because their needs were assessed. We checked that 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 changed to Requires Improvement. The service was in breach of legal regulation in relation to need for consent. However, children and young people’s outcomes were consistently good.

This service scored 71 (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, wellbeing 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.

However, the lack of second consultant led handover in 24 hours meant there was a potential impact on discharge planning. There was a risk children and young people stayed in hospital longer than they needed to.

The service planned and delivered children and young people’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

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 were 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 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 children and young people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

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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.

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 child and adolescent mental health service (CAMHS) liaison team which provided weekend support and were included in handovers.

However, the lack of second consultant led handover in 24 hours meant there was a potential impact on sharing information among the medical and nursing teams. This meant there was a risk senior clinical oversight was not possible.

The service supported children and young people to manage their health and wellbeing 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 that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of children and young people themselves.

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 `National Clinical Audit of Seizures and Epilepsies for Children and Young People' where the results demonstrated compliance above the national average. The `National Paediatric Diabetes Audit 2022/23' had good results for long term blood glucose levels. However, the results highlighted challenges regarding continuous glucose monitoring (CGM) technology as families were unable to self-fund for the monitors.

This 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 did not always tell children and young people about their rights around consent and did not always respect their rights when delivering care and treatment.

Records showed a lack of understanding of the Mental Capacity Act, Mental Health Act, restraint and consent. Staff were not confident and lacked demonstrable legal compliance knowledge. For example, staff referred to actions taken in a patient’s best interest but had not completed a mental capacity assessment or best interest decision. There were no restraint care plans, despite being a regular aspect of care provision. Since our inspection, the service had identified gaps in recording and had agreed to provide staff with additional training and development.