• Hospital
  • NHS hospital

Goole & District Hospital

Overall: Good read more about inspection ratings

Woodland Road, Goole, Humberside, DN14 6RX (01405) 720720

Provided and run by:
Northern Lincolnshire and Goole NHS Foundation Trust

Important: We are carrying out a review of quality at Goole & District Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.

Latest inspection summary

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Overall inspection

Good

Updated 2 December 2022

Goole and District Hospital (GDH) is one of the three hospital sites for Northern Lincolnshire and Goole NHS Foundation Trust. It is located in Goole and serves the population of East Riding of Yorkshire and North Lincolnshire.

GDH is the trust’s smallest hospital. The hospital provides non-acute medical care, elective surgery, outpatients and diagnostic imaging and midwifery led maternity services for children, young people and adults primarily in the North East Lincolnshire area. The neuro rehabilitation centre is at GDH, the centre offers specialist services for individuals following severe brain injury and a range of other neurological conditions.

Medical care (including older people’s care)

Good

Updated 7 February 2020

We previously inspected medical care services at this site under this trust and overall rated it as requires improvement with requires improvement in safe, effective and well-led, and good in caring and responsive.

At this inspection we rated the services as good because:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • The service had enough nursing and medical 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 staffing levels and skill mix and gave bank and agency staff a full induction.
  • The service managed patient safety incidents well. Staff recognised incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.
  • The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.
  • Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patient’s consent. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.
  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. The service included patients in the investigation of their complaint.
  • Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.
  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events. Staff contributed to decision-making to help avoid financial pressures compromising the quality of care.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

However:

  • Compliance rates for mandatory training for medical staff were poor. The 85% target was not met for any of the ten modules. We saw the trust had an action plan to improve compliance. The plan was medical staff would be compliant by November 2019.

Minor injuries unit

Good

Updated 15 April 2016

We found the minor injuries unit at Goole and District Hospital to be good for the effective domain. We did not rate the service in relation to the other four domains.

Evidence-based care and treatment was provided although some of the guidelines were past their review dates; work was taking place to action this.

We found the unit fully supported all grades of staff in their development. There was good multidisciplinary working. However, there was no service level agreement with the local mental health trust as to how long it would take them to come and assess a patient.

Given that this was a small unit in a small hospital there was good access to services seven days a week. Staff we spoke with showed a good knowledge of consent procedures, the Mental Capacity Act, and the associated Deprivation of Liberty Safeguards.

We were told of a recently conducted mental health audit. Apart from this, there was no further evidence presented to us regarding the measurement of patient outcomes.

Maternity

Good

Updated 7 February 2020

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

  • The service provided care and treatment based on national guidance and best practice. Staff completed and updated risk assessments for each woman and took action to remove or minimise risks. Staff were competent for their roles.
  • Staff understood how to protect women and children from abuse and the service worked well with other agencies to do so.
  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff carried out daily and weekly safety checks of specialist and emergency equipment, and the service controlled infection risk well.
  • The service used systems and processes to safely prescribe, administer, record and store medicines.
  • Staff treated women with compassion and kindness, provided emotional support, respected their privacy and dignity, and took account of their individual needs. Staff supported women to make informed decisions about their care and treatment and followed national guidance to gain patients’ consent.
  • The service had an open culture where patients, their families and staff could raise concerns without fear. The service treated concerns and complaints seriously, investigated them and shared lessons learned with staff.
  • The service provided mandatory training in key skills to all staff; however, they did not make sure all staff completed it. Completion rates for safeguarding adults’ training and Mental Capacity training were low among community midwifery staff.

However:

  • We were not assured leaders had oversight of clear and reliable midwifery and nurse staffing data; and we saw sickness rates were high. Community caseloads, allowing for some changes in allowances and changes in NICE Guidance since 2009, exceeded the recommended ratio of 96 to 98 cases per WTE midwife. A high proportion of community clinics had been cancelled in the 12 months prior to inspection.
  • Leaders and senior staff had the necessary experience and knowledge to lead effectively. However, there had been some instability in the leadership team. Staff expressed concerns about leadership stability and the implementation of new models of care; and described morale within the service had wavered.
  • We saw a continued pattern of decline in use of the midwife-led birth suite at the hospital. No decisive action had been taken to ensure the sustainability of the unit, and there was no local vision for the maternity service and a strategy to turn it into action.

Surgery

Good

Updated 7 February 2020

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 it.
  • The service had enough nursing and medical 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 staffing levels and skill mix and gave bank and agency staff a full induction.
  • The service managed patient safety incidents well. Staff recognised incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.
  • The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.
  • Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patient’s consent. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health. They used agreed personalised measures that limit patients' liberty.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.
  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. The service included patients in the investigation of their complaint.
  • Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.
  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events. Staff contributed to decision-making to help avoid financial pressures compromising the quality of care.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

However:

  • In theatres some equipment had gaps in its checking regime. While staff explained this was due to theatres being closed on those days, the system for recording this needed to be improved.
  • In theatre recovery and prior to transfer back to a ward, staff were not totalling their observation scores to create a national early warning score (NEWS) score, for use by ward staff. This did not appear to comply with the trust’s policy. We raised this with staff and were told the issue would be addressed.
  • Even though it was clear the trust was going through a further period of change, it was noted that a clearly defined plan, with approved budgets and milestones, to realise the ambition for surgery at the Goole site, was still in progress.
  • While the overall governance system functioned, we did find instances in the evidence we reviewed that suggested governance needed tightening up. For example, in theatres at Goole, the new form used in theatres recovery was released for use by staff even though key information was missing from the form. In theatres, NEWS totals were not being calculated for sharing on handover to ward staff. This was arguably in non-compliance with the trust’s own policy in this area. In ward areas, for instance, one surgical healthcare team were not completing the space provided on the consent form for re-consenting the patient on the day of the procedure.
  • While staff did have access to information to manage their service, various sources of information we reviewed suggested that data management and reliability were an issue for the trust.
  • For the surgery division at the Goole site, we saw little evidence of learning, continuous improvement and innovation.