Fairfield General Hospital

Updated 22 December 2022

Our rating of services improved. We rated it them as outstanding.

A summary of our findings about this location appears in the overall summary of the provider report.

Updated 22 December 2022

Updated 7 February 2020

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

• The service did not make sure medical staff completed mandatory training. The design of the unit did not meet national guidance. The service did not have enough allied health professionals with the right qualifications, skills, training and experience to provide the right care and treatment. The service did not manage patient safety incidents well. Staff frequently recognised and reported incidents and near misses.
• Doctors, nurses and other healthcare professionals worked together to benefit patients but there was limited participation in multidisciplinary working.
• Leaders did not always use systems to manage performance and risk.
• The service did not have a vision for what it wanted to achieve, and the governance arrangements were not robust. Processes were not in place to manage performance and risk. The service was not focused on the needs of the patient.

However:

• People could access the service when they needed it and received the right care promptly. Staff were caring and compassionate and relatives were involved in decision making processes.
• There were enough nursing staff to safely care for patients on the unit and mandatory training levels had been achieved. Safeguarding processes were in place and staff knew how to recognise and report abuse.

Updated 7 February 2020

Our rating of this service improved. We rated it as outstanding because:

• Patients and families were truly respected and valued as individuals and empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service. Staff consistently went the extra mile to ensure that patients received individualised care that took account of their needs and preferences in the last days and hours of their lives and that their relatives were supported practically and emotionally.
• Services were tailored to meet the needs of individual people and delivered in a way to ensure flexibility and choice. Staff actively engaged with local patient groups and communities to tailor services to meet their needs. Decisions which affected the service were made with patients and their families at the centre.
• The service had enough staff to care for patients and keep them safe. Staff had training in key skills and understood how to protect patients from abuse. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Services were delivered flexibly and were accessible to people when they needed it. There was a bereavement nurse working within the local coroner’s office to provide bereavement advice and support to people who would otherwise have to actively seek this out themselves.
• Managers and staff continually engaged with religious communities to tailor services to meet their needs. Staff had worked together to carry out people’s religious and spiritual wishes after they had died such as preserving the integrity of the body and facilitating vigils or religious ceremonies.
• Leaders had an inspiring shared purpose and strived to deliver and motivate staff to succeed. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However

• The service did not have its own palliative care consultant, although staff had access to specialist palliative care advice and support 24 hours a day, seven days a week.
• We did find one policy that was out of date, although this had been reviewed and was awaiting final sign off.
• Not all IT services allowed easy access to data.

Updated 12 August 2016

We judged outpatients and diagnostic imaging services as Good overall this was because

• • • • • • • Staff were confident about raising incidents and told us that they were encouraged to do so.
          • Staffing levels were appropriate to meet patient needs although increased demand on the Radiology services meant some reporting on diagnostic imaging is outsourced overnight to ensure that turnaround times for reports are within national guidelines.
        • There were appropriate protocols for safeguarding vulnerable adults and children and staff were aware of their roles and responsibilities in regard to safeguarding.
      • The departments inspected were visibly clean and staff followed good practice guidance in relation to the control and prevention of infection.
  • We observed that the equipment used in the care and treatment of patient’s was clean and in good work order.
• An electronic patient record system allowed the filtering out of relevant information and facilitated information being available to different teams very quickly.
• Outpatient and diagnostic services were delivered by caring, committed and compassionate staff who treated people with dignity and respect
• Departmental managers were knowledgeable and supportive and had vision improve their services.
• Staff in outpatients and diagnostic services, demonstrated good team working (including multidisciplinary working) and were competent and well trained.

However

• Not all notes had been scanned and paper notes were still in use for some patients.

Updated 1 March 2018

Our rating of this service improved. We rated it as good because:

• The service had a good record of reporting patient safety incidents.
• The trust’s ‘open and honest’ boards displayed information about staff and safety issues for patients and visitors.
• All areas we visited were visibly clean and free from clutter.
• Medicines were managed well and patient records were securely stored and completed appropriately.
• Staff understood how to manage any safeguarding concerns and this was part of mandatory training requirements that were monitored by managers weekly.
• The trust had recruited both nursing and medical staff and staffing was identified on department risk registers. Staffing was monitored daily and any shortfalls were supplemented with bank and agency staff to ensure sufficient numbers of suitably qualified staff.
• There was a site-specific major incident plan and staff were familiar with this.
• Ward managers were supportive of staff and proud of services provided.
• The trust values were displayed in public areas and there was a strategy in place that included action plans to improve services. There was a positive culture where managers valued staff.
• Risk registers were in place across the surgical departments with control measures in place. The trust collected data to monitor and drive improvement.

However

• National guidance recommends that staff in theatre receive training in advanced life support training. However; training provided was for basic life support only.
• The theatre environment was not fit for purpose and it was not clear when proposed refurbishment would take place.
• Patient information boards displayed patient details visible to others.
• Senior managers acknowledged that waiting times for certain specialities was a challenge with operations being cancelled for non-clinical reasons.
• We found that the service did not investigate complaints in a timely manner, although managers recognised this.
• The surgical safety checklist compliance figures had been supplied but we observed some gaps in the process.

Updated 22 December 2022