- NHS hospital
Croydon University Hospital
Assessment report published 16 July 2025
Contents
Ratings - Medical care (Including older people's care)
Our view of the service
Medical services provided care and treatment in a number of medical inpatient beds located across at number of wards which are all based at Croydon University Hospital and included older people's care.
We carried out this assessment on 1 and 2 April 2025 as part of our system pathway pressures programme. We assessed 24 quality statements across the key questions Safe, Effective, Caring, Responsive and Well-led and have combined the score for each of these areas to give the rating.
During the assessment, we visited a number of wards and assessment units. We reviewed the environment and staffing levels and looked at care records and prescription records. We spoke with patients and family members, staff of different grades, including nurses, doctors, ward managers, therapists, a domestic assistant, and the senior managers who were responsible for medical services. We reviewed performance information about the trust. We observed how care and treatment was provided.
Whilst the service had improved in a number of places since the last assessment at this assessment we still found breaches of legal regulations. At the last assessment the service was in breach of regulation relating to good governance and this was a continued breach at this assessment. We found eight breaches of the legal regulations in relation safe care and treatment, consent, premises and equipment, medicines management and good governance as well as staffing at this assessment.
The service was working to embed a culture of safety and continuous improvement but systems were not always fully effective. The service worked with people and healthcare partners to establish and maintain safe systems of care; however some systems were less effective especially around discharge processes to ensure continuity of care and ease flow through the care pathway. Staff did not consistently assess the risk to the health and safety of service users or maintain good standards of medicines management. Equipment was not always kept safe and staff did not always apply the Mental Capacity Act 2005 in line with guidance and legislation.
There were areas where the skill mix of staff on wards was not in line with national guidance and levels of training compliance needed to improve. Senior leaders did not always ensure that systems to monitor and improve were effective and there were areas that were still not meeting the fundamental standards of care.
However, care was provided in line with national best practice guidelines and medical services participated in the majority of clinical audits where they were eligible to take part. Staff had a strong understanding of how to keep people safe from abuse or harm and followed good infection control procedures. Staff teams worked well together when assessing people's needs and shared information. Patients told us that staff were caring, kind and respected their wishes. The service was providing person centred care and meeting individual needs for patients who had dementia or required palliative care. There were governance and risk management processes in place and services were working with other organisations and system partners. Improvement plans were being put in place but not fully embedded at the time of the assessment for us to assess the effectiveness.
We have asked the provider for an action plan in response to the concerns found during this assessment.
People's experience of this service
Patients and their families were positive about staff who were treating them with warmth, kindness and respect. During our assessment we observed that staff were kind and compassionate, responding to patients' needs in a timely way.
Patients told us, and we observed, that they were offered food and drink and there was a choice of food and in the majority of cases a choice of hot food. Some patients and families reported there had been a lack of communication about delays in tests and investigations which had impacted on their planned discharge date. However, we did observe positive examples of how the service provided information to patients.
Patients and their relatives told us that although there had been delays in being transferred to the wards, staff had been caring and kind. Patients told us that staff were responsive to their needs. However, some patients reported less positively about pain control. The service was responding to this. There were challenges around the flow through the hospital which was having a negative effect on the patient experience at times.
Patients privacy and dignity was maintained and where patients required additional support due to their needs, there were additional staff available to support ward staff to meet these needs. Staff showed kindness and understanding when supporting families whose relatives were at the end of life. Patients and relatives knew how to raise concerns and complaints and were able to share their experience for the service to support learning.
However, a number of people we spoke with told us that at times it was difficult to locate the ward and service they needed as there had been changes to the location but the signage had not been amended. We also observed this during the inspection.
We tracked the experiences of six patients on medical wards from admission, the findings of which had been consolidated within the main body of the report.