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Salisbury District Hospital Good

All reports

Inspection report

Date of Inspection: 2 October 2013
Date of Publication: 8 November 2013
Inspection Report published 08 November 2013 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 2 October 2013, observed how people were being cared for and talked with people who use the service. We talked with staff and reviewed information given to us by the provider.

Our judgement

There were enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

At the time of our visit in February 2013, we were not assured patients were being cared for by enough skilled, qualified and experienced nursing and health care staff in the hospital. The Trust provided us with a series of reports detailing the improvement plans and actions it was taking. Part of their improvement plan had been to recruit over forty nurses. The nursing director told us this had now been completed with the staff working across the majority of wards.

Patients we spoke with during this visit said they were not concerned about staffing levels. One patient told us "my experience has been good here; the staff are extremely nice and do their best”. Other comments made to us included; “they (the nurses) are so busy but they look after me very well”, “staff answer the buzzers quickly, except sometimes at night”, “they are so wonderful”.

We met with four senior ward staff from different areas within the hospital. All of them told us about how they were meeting with senior managers to review the staffing levels and skill mix in their respective areas over the coming weeks. One told us “it a very positive move by the Trust and it gives me the opportunity to make improvements to the staffing levels. Another told us “I’m looking to increase the night staff on my ward in response to rising workloads and the review will enable me to do this”.

We looked at the staffing rotas in the areas we visited and these reflected the current staffing levels. Not all the staff we spoke with felt there were enough staff on duty at night. One staff nurse told us “there are only two qualified nurses on duty on the ward at night and we could do with another to cover breaks and medicine rounds”. Another told us “it can be difficult at night when staff are newly qualified and need more supervision”. We spoke with the nursing director about these concerns and she confirmed they would be looked at as part of the forthcoming reviews.

In the areas we visited across the hospital we saw there were sufficient staff to look after patient’s needs and no one had to wait long for assistance. We observed staff talking with and reassuring people, as well as providing clinical care and treatment. We saw the systems used by the hospital for reviewing staffing levels took into consideration dependency of patients as well as overall numbers. Staff we spoke with told us staffing on each ward was reviewed twice daily at the hospital bed management meetings. Where staffing shortages were identified staff were transferred from other wards and/or bank or agency staff were brought in.

One of the Medical Consultants told us “the staffing numbers have definitely improved over the last six months; the situation is a big improvement on the previous one”. We met three of the new nurses employed and they told us how they felt supported and looked after by the Trust. Two nursing staff told us how the ward administrators had made a positive impact on the administrative tasks for nurses.

The introduction of the new staff and the on going recruitment drive for newly qualified staff had significantly improved the staffing situation since February 2013. The Trust told us it was an on-going process to maintain recruitment to meet its own targets. Staff and patients we met at the hospital told us they felt the current levels were safe, with any unplanned shortages addressed quickly without compromising patient care.

We had previously been concerned about how staffing levels were reported and considered at Trust board level. The Trust provided us with a range of reports from both the nursing and human resource directors which showed how this was now reported. They showed whether the hospital was meeting staffing levels, the use of agency and bank staff, unfilled vacancies and sickness levels.