Good Hope Hospital

Ratings - Medical care (Including older people's care)

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Good

• Responsive

  Requires improvement

• Well-led

  Good

Our view of the service

We carried out this assessment due to the rating of inadequate for the service following the previous inspection in April 2023 and the concerns associated with this. Following this inspection, conditions on the provider's registration were imposed. However, the service had provided evidence since that inspection to satisfy us the conditions had been met. We therefore returned to complete an onsite assessment to review how these improvements had been embedded.

During our assessment we visited wards 8, 9, 10, 11, 12, 15, 23, 24, 28 acute medicine unit, endoscopy and the discharge lounge which were attributed to the medical service. We also visited wards 2, 16 and 29 where medical patients were admitted on non-medical wards. We spoke with 74 staff which included matrons, consultants, nurses, junior doctors, nurse associates, healthcare assistants, allied health professionals, flow coordinators, domestic staff, student nurses and ward clerks. We observed care and treatments and reviewed 22 complete patient records and an additional 18 medicine records.

We assessed 25 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined these scores with the scores from the last inspection to give the current rating. The rating following this assessment improved to requires improvement overall, with caring and well-led rated as good.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Regulation 9 Person Centred Care and Regulation 12 Safe Care and Treatment. This related to the concerns identified within the resuscitation and escalation of treatment documentation completed for patients (Regulation 9) and medication concerns, flow and capacity concerns and the resuscitation training compliance which was below the trust target across most of the wards within the service (Regulation 12).

However, the service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks, and there were now enough staff to provide care to patients.

Staff delivered care based on latest evidence and good practice. People always had enough to eat and drink to stay healthy. Staff monitored people’s outcomes. However, these were not always positive or consistent. Staff made sure people understood their care and treatment to enable them to give informed consent.

Staff treated people with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. Staff mostly responded to people in a timely way. The service supported staff wellbeing.

The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it.

The service was mostly led by strong, supportive and visible leaders. There had been improvements in the culture of the service and the governance and risk management processes used by the service.

People's experience of this service

During our onsite assessment we spoke with 18 patients and 3 relatives. People and their family members who were with them were all positive about staff treating them with warmth and kindness and providing effective care and treatment. People told us staff mostly responded to their needs in a timely manner and provided clear information about their conditions. People were given options for their dietary requirements and most patients told us the food was nice, and they received enough to meet their requirements. People told us staff had taken an interest in their likes and dislikes and where able met their individual needs, for example where a patient liked to listen to the radio, staff provided them with this.

People were generally happy with the care and treatment staff were providing them. However, if they had any concerns, they did not feel they would be unable to raise them.