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The National Hospital for Neurology and Neurosurgery Good

All reports

Inspection report

Date of Inspection: 12 November 2012
Date of Publication: 20 December 2012
Inspection Report published 20 December 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We reviewed all the information we have gathered about The National Hospital for Neurology and Neurosurgery, looked at the personal care or treatment records of people who use the service, carried out a visit on 12 November 2012 and observed how people were being cared for. We checked how people were cared for at each stage of their treatment and care, talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

People mainly experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People experienced care, treatment and support that met their needs and protected their rights. When we spoke to patients, most were very positive about the care they had received. They told us appreciated the knowledge and skill of the medical staff and felt the nursing staff were caring. We received the following comments about care at the hospital:

“I was admitted five days ago, the care is generally good and they do the clinical checks thoroughly and regularly.”

“I find the night staff less attentive and a few can be quite abrasive.”

“I am having physiotherapy and it is very good.”

“The staff are great, especially if you need to be admitted to a ward.”

“I think the care has been good, although they could speed it up somewhat.”

“Once you are seen the treatment is good and the communication is clear.”

Neuromedical Intensive Care Unit (MICU), Neurosurgical Intensive Care Unit (SICU) and High Dependency Unit

We spoke with two patients on the MICU and they told us they were extremely happy with the care that they had received. They told us they always had confidence in the nurses that were caring for them. We also spoke to two relatives on the SICU, who also had no concerns and gave positive feedback about the care their relative had been receiving.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed the nursing documentation on the MICU and SICU, which was held on a computer. There was evidence that care was being delivered in a professional, competent and caring manner. All aspects of daily living were included and easy to cross reference with medical records, other investigations and multi-professional input. When we spoke with staff on the MICU they told us they felt it was very important to try and provide holistic care that met the patients’ social as well as medical needs. For example, they told us they would arrange for support so that patients who were able could be accompanied to spend some time away from the ward.

Lady Anne Allerton (LAA) and David Ferrier (DFW) wards

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. When we looked at the nursing paperwork on the wards there was evidence that appropriate risk assessments, for example potential for falls or pressure damage, had been completed. We were told there were daily multi-disciplinary team meetings on the wards and that the discharge team visited daily. A weekly multi-disciplinary team meeting also took place to discuss complex cases. When we spoke to nursing staff on LAA ward and they told us they felt they had good access to physiotherapy and occupational therapy. There were staff allocated to the ward and they were always available.

People were protected from the risks of inadequate nutrition and dehydration. When we observed lunch on a ward we saw people were being given appropriate support with eating.

When we observed nursing care on the wards we saw nurses offering appropriate support to patients when they required it.

Outpatients

When we visited the Outpatients department a spinal neuro-surgery clinic was taking place, which was running late. It was very full with not enough seats and some people standing or sitting on ledges. We asked patients about their experiences at the clinic, they told us the following:

“I have been coming to this clinic for 22 years and my appointments are four times a year. At least 50% of my appointments I need to wait, probably for an hour.”

“This is my second appointment. Last week I sat and waited for three hours.”

“There was no communication and I was very worried about what I was going to be told.”

“I have been coming to this clinic for several years. I have never waited for less than an hour and I would like to know my waiting time. We are never told why we have to wait. “

We asked the manager about waiting times in outpatients and she said there were three c