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Archived: Samuel Johnson Community Hospital Good

This service was previously managed by a different provider - see old profile

Reports


Inspection carried out on 7 - 9 July 2015

During an inspection to make sure that the improvements required had been made

Samuel Johnson Community Hospital is part of Burton Hospitals NHS Foundation Trust. The hospital provides a number of services to the local population of Lichfield, working closely with neighbouring hospitals and NHS trusts.

We inspected this hospital in July 2015 as part of the comprehensive inspection programme.

Overall, we have rated this hospital as good. We saw that services were caring and compassionate. We also saw that people have good outcomes because they receive effective care and treatment that met their needs. Systems and processes were in place to ensure patients were kept safe and were able to respond to local need. The minor injuries unit required improvement in order for it be considered responsive to people’s needs and well led.

Our key findings were as follows:

  • Staff were caring and compassionate towards patients and their relatives. Patients’ dignity and privacy was ensured and we saw many examples of good care right across the trust for staff at all levels.
  • There was a strong open culture and staff were encouraged and supported to report incidents. There were clears systems in place to ensure lessons were learnt and services developed as a result
  • The hospital delivered an effective and responsive service that met the needs of the local community.
  • Staff at Samuel Johnson hospital described how the computer systems at the hospital were not all compatible with those at the trusts other sites. Provision had been made so that information was available, but this was read only.

We saw several areas of good practice:

  • Dementia care was embedded within the wards. Nurses, nursing assistants and volunteers were trained as dementia champions; they encouraged others to make a positive difference to people living with dementia.
  • Multi-disciplinary working was embedded on the wards. The ward based physiotherapists and occupational therapists (OT) supported the nurses in the patient rehabilitation pathway and promoted safe patient independence during their rehabilitation programme.
  • We heard of the strong emphasis on a drive for quality, good communication and ongoing enhancement of staff’s skills.
  • We saw good examples of multi-disciplinary team (MDT) working across the maternity service. Staff worked collaboratively as part of the multidisciplinary team to serve the interests of women in birthing at the unit and those cared for in the community setting.

However, there were also areas where the trust needs to make improvements:

Importantly the trust must:

  • The trust must review arrangements for responding to patients with mental health needs in the minor injuries unit.
  • The trust must review arrangements for access to x-ray imaging after 5pm weekdays and on Saturday afternoons and Sundays or MIU patients.
  • The trust must support the MIU to audit its performance in order to assess the effectiveness of their own practice and to identify and manage risks.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Inspection carried out on 24-25 April and 7 May 2014

During a routine inspection

Samuel Johnson Community Hospital is one of the three locations that Burton Hospitals NHS Foundation Trust provides services from. The other locations are Queen’s Hospital and Sir Robert Peel Community Hospital. We inspected the hospital between 24 and 25 April 2014.

Samuel Johnson Community Hospital provides a range of services including rehabilitation, care of older people, general medical care, outpatients, minor injuries service, diagnostics and midwifery-led maternity services. The inspection team inspected the minor injuries unit (MIU), medical care (including older people’s care); and maternity services during this inspection.

In the last 12 months 30,000 patients attended the minor injuries unit. Before and during our inspection we heard from patients, relatives, senior managers and other staff about some key issues that were having an impact on the service provided at this trust. We also held a listening event in Burton where patients and members of the public were given an opportunity to share their views and experiences.

Why we carried out this inspection

Burton Hospitals NHS Foundation Trust had a significantly higher than expected mortality rate from April 2012 to March 2013. As a result, the trust was included in Professor Sir Bruce Keogh’s review of trusts in 2013. The overview report Review into the Quality of Care and Treatment provided by 14 Hospital Trusts in England is available on the NHS Choices website. The Keogh review identified a number of areas of good practice. However, the report identified a number of areas of concern, such as no systematic approach to ensure the collection, reporting and action on information about the quality of services. It also found that there was a lack of support for junior doctors, and that medical staffing levels and skills mix were not appropriate and equipment safety checks had not been carried out.

We inspected this hospital as part of our in-depth hospital inspection programme. When we inspected the trust in April 2014, 14 of the 61 recommended actions following the Keogh inspection had still to be completed.

Overall, Samuel Johnson Community Hospital was rated as good. This hospital was rated as good for providing services that are effective, caring, responsive and well-led. However, it requires improvement in providing safe services.

Our key findings were as follows:

  • Ward staff were committed to delivering high quality care and saw patient experience as a priority.
  • Recruitment is a recognised challenge for the trust, with some wards below establishment. Bank, agency and locum staff were used to fill vacant posts and some staff worked additional hours. In some areas there was a high dependency on temporary nursing staff.
  • There were procedures in place for staff to learn from incidents and implement changes.
  • There were systems in place for monitoring the safety of the environment and equipment.
  • Staff had access to and attended mandatory training.
  • Clinical areas were clean and there were policies and procedures in place detailing cleaning schedules.
  • Documentation for children attending the MIU lacked specific prompts and did not include evidence such as the names of parents/guardians accompanying children or if the child or family had contact with social services.
  • Translation services were available on request.
  • There was a trust complaints policy and procedure for managing complaints. Staff were made aware of the outcome of complaints. However, the trust set a timeframe of 35 working days to respond and this was not always met.
  • The hospital does not always meet the needs of all patients living with dementia.
  • Some specific equipment, such as adjustable beds for people who were at a high risk of falls, was not always available.

We saw areas of outstanding practice including:

  • The arrangements to cover unexpected midwife absences. A system alerted staff by a text message to inform as many midwives as possible that replacement staff were required. Staff were very positive about the efficiency of this system.

However, there were also areas of poor practice where the trust needs to make improvements.

Importantly, the hospital must:

  • Take action to ensure documentation for children attending the MIU records appropriate information.
  • Take action to ensure the care for people living with dementia is embedded throughout the hospital.
  • Review the systems and processes for responding to complaints within the agreed timescales.

In addition the hospital should:

  • Consider reviewing the availability of equipment such as adjustable beds.

Professor Sir Mike Richards

Chief Inspector of Hospitals