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Tameside General Hospital Good

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

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Inspection report

Date of Inspection: 11, 15 May 2013
Date of Publication: 11 July 2013
Inspection Report published 11 July 2013 PDF | 93.61 KB

Overview

Inspection carried out on 11, 15 May 2013

During an inspection in response to concerns

We carried out this responsive inspection of the trust’s emergency care pathway, risk management and incident reporting. We carried out the inspection after correspondence from the North Western Deanery and viewing a report of a review of urgent care commissioned by the trust raised concerns about patient safety and the quality of service provision in the accident and emergency department and escalation areas at the trust. We were told there was a culture of under reporting of incidents, problems of overcrowding and delays in ambulance handovers, poor implementation of discharge planning and a lack of regular team meetings for staff.

We spoke with people about their journey from accident and emergency to admission. We asked them about their understanding of what was happening and if staff had explained what was wrong with them, what treatment was needed and if discharge arrangements had been discussed. People told us “I can’t fault anything.” They told us staff had “put them at ease” and felt they had been given “excellent attention” when they arrived at the department. They told us that “everybody has been good” and that “the doctor talked me through everything’.

On both occasions we visited the trust the accident and emergency department was quiet. There were a number of beds available on wards and departments so escalation procedures were not operational. We observed the handover process for patients brought into the accident and emergency department by ambulance. We found that handovers took place in a corridor. This meant that the privacy of patients’ confidential information was not always respected.

We found that the trust had an escalation policy in place and the designated escalation area was fully equipped to manage escalated patients if required. We were told by staff, patients and the review of urgent care commissioned by the Trust that the application of the escalation policy was not always consistent. This meant that there was a risk that people could experience unsafe and inappropriate care.

We found that three bed management and discharge planning meetings took place every day but consultant input to ward rounds was limited to three days a week. This meant that there had been improvements to discharge planning but more work was needed to implement and manage discharge processes consistently across the trust.

Staff told us that there had been an increase in meeting frequency between ward based and senior staff. Some staff told us that staff meetings were sometimes cancelled when the ward was busy. This meant that learning from incidents, adverse events and errors was not always shared.

We found that the trust had systems in place to assess and monitor the quality of services. However these systems were not always robust enough to ensure that all risks were identified by the trust and effectively managed. This meant that timely action was not always taken to protect people who use the services.