King's Mill Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We rated safe as good. We assessed 3 quality statements. There was a positive learning safety culture where events were investigated, and learning was embedded to promote good practice. Leaders had increased staffing levels when needed to keep the department and people safe. Staff were trained and competent and had the right skills to meet people's needs. Staff followed national infection, prevention, and control practices. There were clear processes and policies, to ensure the environment was kept clean.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were confident to report incidents and supported when things went wrong. Staff knew what they should report and when. The trust’s formal reporting system was easy to use. Staff saw incidents as an opportunity to learn and improve.

Staff had effective systems to raise concerns both formally and informally. Reports were analysed and urgent actions taken by leaders to manage or remove risks.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff we spoke with told us they received training appropriate and relevant to their role. They were given opportunities to learn, and poor performance was managed appropriately. Staff told us they received the support they needed to deliver safe and effective care. This included supervision, appraisals and support to develop, improve services and where needed, professional revalidation. All staff we spoke to had advised within the past 12 months they had completed sepsis training, and were aware of the sepsis screening tools both for adults and children. The trust had an appointed sepsis nurse. All staff both in adult and the children’s emergency department, were aware of the trust sepsis nurse and how to contact them. Leaders reviewed staffing numbers regularly to ensure safety, and a suitable skill mix increasing numbers as much as possible when the department had higher numbers of people attending for emergency care. However, staff we spoke with raised concerns that staffing was not always safe . Identified staff numbers were not always adhered to. After our assessment, the trust provided us with assurance that staff shortages were appropriately managed and mitigated.

Staff were noticeably busy and worked under pressure when the department had higher numbers of patients or when people required close supervision. There was a good degree of support and mutual respect among staff working in the department. During our assessment we saw there were enough staff to provide care and support to people safely. We observed good examples of positive engagement between staff, people and their care givers including discussion around the admission to hospital and proposed treatment.

Records showed there were enough medical staff to meet the recommendations of the Royal College of Emergency Medicine. When locum doctors were needed, they had training in emergency medicine. Records showed the nursing and healthcare assistants mostly achieved the approved staffing numbers but were supplemented at times by bank and agency staff. There were enough staff with the right training and qualifications to safely treat children. There were up-to-date policies and procedures, which were accessible to staff through the trust’s intranet site.

All staff we spoke with said they had received a meaningful appraisal within the last year. Appraisal rates for nurses were 94% and for allied health were 100% with an overall rate for all ED staff of 93% against the trust target of 90% This meant staff were provided with an opportunity to discuss, reflect, or review what was working well, and what could be improved at the service.

Staff received mandatory training for infection prevention and control and followed protocols to ensure that people were protected from the risk of infection. Staff followed national infection, prevention, and control practices. There were clear processes and policies, to ensure the environment was kept clean, including the use of personal protective equipment (PPE). We saw there was enough equipment available for staff to keep patients safe.

All staff we spoke with were clear on their individual roles and responsibilities concerning infection prevention and control.

Personal protective equipment (PPE) such as disposable gloves and aprons were available in all locations. We observed the appropriate use of PPE. For example, staff wore aprons and gloves when caring for patients.

During our assessment, we observed all staff were bare below the elbows.

We also observed ‘I am clean’ labels were on beds in the Senior Triage Rapid Emergency and Assessment Management (S.T.R.E.A.M) area. This meant that cleaning had taken place for those beds, which were now ready for the next patient.

We observed all staff using the hand washing facilities available in examination and treatment rooms. Alcohol gel dispensers were visible and in use.

All locations we visited were visibly clean, and had suitable furnishings which, were clean and well-maintained.

There were clear processes and policies, to ensure the environment was kept clean, including the use of personal protective equipment (PPE).

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.