Good Hope Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We rated responsive as requires improvement which remained the same as the previous inspection. We reviewed 4 quality statements during this assessment.

People were not always able to access the care, support and treatment they needed, when they needed it.

However, people were at the centre of their care and treatment choices. Staff provided appropriate information in formats which met the needs of the patient. Staff made it easy for people to share their feedback, ideas and complaints about their care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care plans reflected their physical, mental, emotional and social needs. Patient records were mostly completed electronically. Staff selected which care plans were required for each patient and then regularly reviewed and completed progress notes. We reviewed 22 sets of records and found these reflected the patients’ needs. Staff regularly reviewed people’s needs and updated records when things had changed.

People received the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. Where patients were identified with complex and additional needs, staff ensured these needs were met. Where additional support was required, staff ensured the relevant teams were involved in the patient’s care which included but was not limited to the vulnerabilities and safeguarding team, psychiatry liaison team and dementia nurse specialists. The service encouraged staff to complete and follow ‘All About Me’ documents and hospital passports. These were documents completed by relatives, friends or carers who knew the person best and gave staff useful information to help provide person-centred care.

Audits of the dementia strategy were completed across all sites, this included auditing the knowledge and completion of the ‘All About Me’ document. Ninety percent of staff were aware of these documents and 88% of documents had been completed for patients which was the highest out of all the trust’s 4 hospitals. This demonstrated staff were keen to ensure they were meeting the needs of all patients in their care. It was also noted the vulnerabilities team were instrumental in ensuring these documents were completed.

People understood their condition, care and treatment options. Patients told us staff discussed their care and treatment with them and regularly updated them on their progress. We observed staff discussing patients medical conditions with them in ways which was easy for them to understand. Staff regularly updated patients on their progress and discussed discharge plans. When patients had communication issues as a result of a disability or sensory loss, staff took action to address these issues and provided the information in ways which met their needs.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff provided people with information which was tailored to their needs. Where patients were known to have an impairment, an alert was placed on their records which supported staff to meets communication needs.

Staff were aware of the process for requesting interpretation and signers for patients who required their services. During our previous inspection, we found information leaflets were mostly available in English with no other languages on display despite staff being able to access information leaflets in other languages. During this assessment, we found information leaflets were still only immediately available in English.

Staff had access to a range of communication aids and some staff had learnt sign language and Makaton to help their communication with patients.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People knew how to give feedback about their experiences including how to raise complaints or concerns. The service clearly displayed information about how to raise a concern in patient areas. Patients told us they felt comfortable raising any issues with the staff caring for them at the time.

People felt their complaints and concerns would be thoroughly investigated. They felt they would receive a response in a timely manner, and that it would be dealt with in an open and transparent way with no repercussions. Managers investigated complaints and identified themes. Staff knew how to acknowledge complaints and patients received feedback from managers after the investigation into their complaint. There were 58 complaints raised between September 2024 and February 2025. The main themes identified were in relation to clinical treatment, communication, patient care and staff attitudes. At the time of the assessment, 8 complaints were being reviewed independently following closure by the trust, 3 of which had a recommendation for a further detailed investigation to be conducted.

Learning from complaints and concerns was seen as an opportunity for improvement and staff gave examples of how they had incorporated learning into daily practice. Staff from Ward 24 were able to share many recent examples of where they had used information from formal and informal complaints to improve care and treatment for other patients who were admitted. This had included requesting additional specialist equipment for patients and implementing plans and protocols for patients admitted with a specialist need. Other wards we visited were also able to share examples of how complaints had been used to improve care and treatment they provided, which had included additional training.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Patients could not always access care, treatment and support when they needed to and in a way that worked for them. There were significant flow and capacity issues throughout the whole hospital which was affecting the timeliness of the care and treatment patients experienced.

The hospital had continued to use the ‘Push’ system which had been operating since our previous inspection. This involved patients being brought onto medical wards to help support the ability of the emergency department to treat patients and offload ambulances. There were processes for staff to follow which tried to ensure all patients remained safe. However, staff from all wards we assessed continued to raise their concerns about this process.

On the first day of our assessment, due to severe capacity issues within the emergency department, staff told us patients were moved to the wards as early as 5.30am. Patients remained on the corridors within these wards for extended periods on this day while awaiting a bed on the ward to become available. Staff told us patients were more frequently being pushed out to the wards regardless of whether there were patients due to be discharged which was causing concern and dissatisfaction among patients.

We spoke with patients who were moved on to wards as part of the push process who acknowledged that while staff had been kind and considerate of their needs, having care provided within the corridor did not meet their needs. We observed a patient trying to ask staff about the situation and why they were being cared for in the corridor. However, staff struggled to provide all the answers to the patient, especially around how long it would be before they were admitted into a ‘proper’ bed.

Staff told us they were increasingly escalating patients to the site team due to the extended time they remained in the corridors. Some patients were transferred to other wards when beds became available. However, in some circumstances patients had to remain on the corridor indefinitely as there was no bed available and no plan at the time for patients to move.

Due to the demands on the service, not all patients who were under the care of the medical specialty were admitted on to medical wards. These patients were known as medical outliers. On the first day of our assessment, there were 105 patients classed as medical outliers. There were now arrangements to ensure all medical outlier patients received the same standards of care as those on medical wards and staff told us this worked well.

There were very few times where staff struggled to get medical patients seen now, which was an improvement since our last inspection. However, staff on other speciality wards, almost all being surgery, told us about the impact this had on the services they were trying to provide, with some patients having care and treatment postponed due to there being no available bed for them due to the numbers of patients who were medical outliers.

Managers and staff worked to make sure patients did not stay longer than they needed to, although this was being increased by delays in community care provided for people who needed this. Staff told us the length of stay on most wards had continued to increase due to the continued delays in discharging patients. Managers also told us the new referral process for social care had recently changed which had meant a lengthened time to seek the appropriate support for patients on discharge.

Hospital data showed the average length of stay for patients admitted under an emergency pathway was 9 days against a hospital average of 10 days. The information showed Ward 28 had the highest length of stay which staff expected due to the nature of the ward (stroke rehabilitation) and the complex needs of patients admitted. Staff also identified the lack of available local community rehabilitation capacity as a significant factor. Ward 12 also had a higher than hospital average length of stay of 14 days. Staff believed this was again down to the nature of the ward (healthcare of older people) and the impact of waiting for social care.

Although there were known issues within the community around discharge, staff started planning this for each patient as early as possible. Staff regularly completed the ‘red to green’ process which ensured oversight of the patient’s readiness for going home. However, where patients were identified for discharge, the service had no effective process to aid the flow of patients.

Due to the demand for beds, the discharge lounge had patients who had been admitted to this temporary unit for up to 10 days and it was therefore not functioning effectively. This was impacting the ability to move patients who were unsuitable to sit in a chair and needed a bed while they waited for discharge. On the first day of our assessment, 7 out of the 8 beds within the discharge lounge were taken up with people classed as medical outliers.

People expected their care and treatment to be accessible, timely and in line with best practice, quality standards and legal requirements. Waiting times were being managed and reducing, although pressures from respiratory illness had put additional pressure on the hospital over the winter.

Managers monitored the waiting times and tried to ensure people could access services in a timely manner. There were no patients waiting over 104 days for cancer treatment and 15 patients had been waiting for 62 days. Information reviewed identified there had been 3,014 new referrals to the hospital in January 2025, which was an increase of 494 from December 2024.

Between November 2024 and January 2025, the hospital had seen a 96% increase in respiratory referrals. There were 241 patients waiting for treatment since their referral for over 52 weeks (but below 65 weeks), no patients were waiting 65 weeks or more. Respiratory medicine was the specialty that had the highest proportion of patients waiting for treatment. The service had worked hard to reduce delays within endoscopy. However, due to recent issues within the department, all capacity would be prioritised to cancer services which meant there was an expectation for the performance to deteriorate.

Patients could access services when they needed it without physical or digital barriers, including out of normal hours and in an emergency. Staff could call for support from doctors and other disciplines, including mental health services and diagnostic tests, 24 hours a day, 7 days a week. The endoscopy unit also provided an on-call service for patients admitted as an emergency for gastrointestinal bleeds. Consultants led daily ward rounds on all medical wards, including weekends. Patients were reviewed by consultants depending on the care pathway.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.