• Hospital
  • NHS hospital

Orpington Hospital

Overall: Requires improvement read more about inspection ratings

Sevenoaks Road, Orpington, Kent, BR6 9JU (020) 3299 9000

Provided and run by:
King's College Hospital NHS Foundation Trust

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

All Inspections

11 July 2022

During an inspection looking at part of the service

We carried out a focused responsive inspection visit to two Older Adult Medicine wards at Orpington Hospital on 11 July 2022. This was as a result of receiving concerning information about standards of care.

We spoke with eight patients, one relatives and 17 staff. A range of information was reviewed by us on site and as provided from the trust after our visit. We looked at seven records related to patient treatment and care. We made observations of staff interactions with patients and one another, how the multidisciplinary team worked, and the general environment.

We found:

  • Staffing levels did not always enable staff to provide the standards of care they aspired to.
  • Not all staff had a full understanding of how to protect patients from abuse. Care and treatment was not always delivered in a responsive manner and did not always reflect the preferences of patients. Patients were not always treated with dignity and respect. Staff did not always feel valued and listened to. As a result, they did not always report matters of concern via the incident reporting system. There were missed opportunities for managers to be informed of these, to investigate and learn from the issues.
  • Medicines were not always managed safely.

However:

  • Staff had training in key-skills and safety related subjects. Infection risks were well managed, and the environment was suitable for patient’s needs.
  • Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from these.
  • Staff ensured patients had enough to eat and drink and ensured their pain levels were assessed and managed. They treated patients with kindness and respected their privacy. Staff provided emotional support to patients, their families and carers.
  • There was good multidisciplinary working and sharing of information. Key services were available seven days a week.

13-17 April 2015

During an inspection looking at part of the service

Orpington Hospital is part of King's College Hospital NHS Foundation Trust and provides medical services to a population of approximately 300,000 people living in the London Borough of Bromley.

King's College Hospital NHS Foundation Trust employs around 11,723 whole time equivalent (WTE) members of staff, with approximately 220 WTE working at Orpington Hospital.

We carried out an announced inspection of Orpington Hospital on 16 April 2015.

Overall, this hospital is rated as being 'good'. Both surgery and outpatients and diagnostic imaging were rated as 'good' overall.

The five key questions, safety, effectiveness, caring, responsiveness and well-led were all found to be was 'good' overall at this hospital.

Our key findings were as follows:

Safe

  • There was a formal process for reporting incidents and near misses and the sharing of information, including learning from incidents that took place.
  • There were effective arrangements in place to minimise the risk of infection to patients and staff.
  • Arrangements were in place to ensure staffing numbers and the skills mix was appropriate to support the delivery of patient care safely.
  • The departments were clean and well maintained.
  • Equipment was readily available and staff were trained to use it safely.

Effective

  • Patients had been assessed, treated and cared for in line with professional guidance.
  • Patients reported that their pain was assessed and treated.
  • The nutritional needs of patients were assessed and patients were supported to eat and drink where their needs indicated.
  • Staff received an annual performance review and had opportunities to discuss and identify learning and development needs through this review and other supervision meetings.
  • There was access to Allied Health Professions services, such as physiotherapy out of hours.
  • There was evidence of multidisciplinary working, which promoted effective patient treatment.

Caring

  • Patients were satisfied and involved with their treatment and care and their privacy and dignity was respected.
  • There was access to counselling and other services where patients required additional emotional and psychological support.

Responsive

  • Patient access and flow through the surgical areas was planned around their needs.
  • The surgical theatres were not always effectively utilised to their full capacity.
  • Arrangements were in place to support people with disabilities and cognitive impairments, such as dementia.
  • Translation services were available and information in alternative languages could be provided on request.
  • The complaints process was understood by staff and patients had access to information to support them in raising concerns.
  • Staff responded to patients’ individual needs and supported them throughout their journey at the hospital during their appointment.

Well-led

  • Staff understood the vision of the trust and hospital and they could demonstrate how this was implemented in practice.
  • Senior leaders understood their roles and responsibilities and monitored the standards of service provision.
  • There were effective governance arrangements to facilitate monitoring, evaluation and reporting back to staff and upwards, to the trust board.
  • The surgical directorates identified actual and potential risks at service and patient levels and had mechanisms in place to manage such risks, as well as to monitor progress.
  • The culture amongst staff was of sharing and participative engagement, with openness to feedback and learning.

There were also areas of poor practice where the trust needed to make improvements.

The trust must:

  • Ensure patients are seen in outpatient clinics with their full set of medical notes.

The trust should:

  • Undertake medication audits in the outpatients and diagnostic imaging department.
  • Ensure that a radiation protection supervisor is onsite.
  • Conduct audits of the radiology reporting times.
  • Undertake daily safety checks of the imaging and diagnostics department.

Professor Sir Mike Richards

Chief Inspector of Hospitals

13 April 2015

During an inspection of this service