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Inspection carried out on 22 October to 28 November 2019

During a routine inspection

Our rating of services stayed the same. We rated it them as good because:

  • The hospital had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The hospital controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The hospital managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • 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, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available five days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The hospital planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the trust’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

  • We found areas of the theatre suite had not been maintained in order to reduce the risks to patients
  • We observed patient records unattended in one ward area.
  • Waiting times were not in line with national standards for some surgical specialities.
  • The surgical service did not have a clear vision for what it wanted to achieve or a strategy to turn this into action. The vision and strategy were dependent on progress in regional developments within the wider health economy. Risk registers did not identify environmental risks we observed during inspection.

Inspection carried out on 6 November 2017

During a routine inspection

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

Inspection carried out on 8-11 December 2016

During a routine inspection

The medical care services at the Leigh Infirmary provide neurological rehabilitation care for those with an acquired brain injury or neurological illness and elective diagnostic procedures such as gastroscopy, colonoscopy and flexible sigmoidoscopy. Taylor ward has 20 beds including 3 side rooms. The endoscopy unit was opened in May 2013 with decontamination facilities on the same site. There are two surgical wards, wards two and three, providing day case and short stay services.

At the Hanover Diagnostic Centre, the hospital offers an extensive range of urology services. The urology department is located in the Richmond unit and offers a range of services for patients including rapid access clinics, prostate assessment, vasectomy, haematuria, one stop and out of hours evening clinics.

The main outpatient clinic areas are situated on the ground floor of the infirmary in six ‘areas’. These areas house a range of clinics covering colorectal, breast and orthopaedic surgery, diabetes, lipids, renal, urology, neurology, anti-coagulation, cardiology, chest, obstetrics and gynecology. The Hanover Diagnostic and Treatment Centre provide clinics for women’s health, urology and endoscopy patients.

Diagnostic imaging and haematology services are also provided at Leigh Infirmary including ultrasound, plain film x-ray, barium enemas, and barium swallows with video-fluoroscopy and video-urodynamics.

We inspected the hospital between the 8 and 11 December 2015 as part of the comprehensive inspection of Wrightington, Wigan and Leigh NHS Foundation Trust.

Overall we found the hospital provided good services across the four domains of effective, responsiveness, caring and of being well led. However they required improvement in safety in medicine and effectiveness in maternity and gynaecology.

Our key findings were as follows:

  • Staffing levels were adequate to meet the needs of patients at the time of the inspection.

  • Staff received training appropriate to their role however uptake of some training could be improved especially in Mental Capacity Act training.

  • Care was provided in clean and tidy surroundings and infection control practice was good. However the environment on Taylor ward did not fully meet the needs of the patients and were not conducive with safe patient care and the storage of waste was not always safe.

  • Food and drinks were available and suitable to meet the varied needs of patients.

  • Discharges from Taylor ward were not always timely.

  • Care was not always supported by robust policies, procedures and guidance and not always adhered to.

  • The use of restraining lap belts on one ward had become custom and practice and individual risk assessments had not been completed.

We saw several areas of outstanding practice including:

  • Urology staff offered ‘one-stop’ appointments for haematuria patients which enabled patients to undergo biopsies during initial appointments rather than having to re-attend on another day.
  • A trust ‘pioneering staff engagement’ programme was in place across a multi-disciplinary team with a number of innovating programmes in progress. The service had received several awards over the past two years.

However, there were also areas of practice where the trust needs to make improvements.

Importantly, the trust must:

  • Ensure safeguarding, mental capacity act (2005) and deprivation of liberty safeguards are in place and followed to ensure patients safety at all times. Processes must be clearly defined, understood and followed by staff.

  • Improve mandatory training uptake particularly mental capacity act training.

  • Ensure that there is adequate space on the wards for patients to receive safe and effective care.

  • Ensure that there are adequate facilities to store clinical waste safely.

  • Ensure care is delivered as per evidence based guidance.

In addition the trust should:

  • Improve the timeliness of patient discharges from Taylor ward.
  • Improve staff annual appraisal rates.
  • Keep trolleys containing patients notes locked
  • Improve the completeness of records particularly with name and designation always clearly recorded and printed and consent forms available to review.
  • Review local rules held in the radiology department and ensure staff can locate them if required.
  • Review dosage instructions for adrenaline administration to treat anaphylaxis and ensure they are satisfied instructions are easy to interpret in an emergency.
  • Review the benefit of documenting processes for organising staffing for outpatient clinics.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Inspection carried out on 23 March and 13 June 2012

During a themed inspection looking at Termination of Pregnancy Services

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.