Cheltenham General Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We rated the safe key question as good. We assessed 2 quality statements, around safe systems, pathways and transitions and safe and effective staffing for the safe key question.

The medicine division had safe systems of care in which patient safety was managed and monitored. Staff ensured continuity of care when people moved between services.

Staff worked together effectively to provide safe care that met people’s individual needs.

Staffing levels varied across the medicine division at Cheltenham General Hospital (CGH) based on the dependency needs of the patients, which varied from day to day.

There were nursing staff vacancies on some of the care of the elderly and stroke wards and some vacancies in the therapy provision. Vacancies were covered by bank and agency staff. Staff on all wards we visited had received training and felt supported. We spoke with staff on the oncology unit and hyper acute stroke unit who reported they felt supported and their learning needs were being met.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

The medicines division worked within a multidisciplinary team structure that included external bodies such as Healthwatch, an organisation that represents and presents to the health and social care providers, peoples experience and views on health and social care, local support networks, including charities and social care providers.

Some people who had suffered a stroke could be discharged early through the early discharge pathway. Staff told us they were aware of these processes and had applied them.

Staff told us at times they had to accommodate people in the corridors due to the demand on services The trust had an escalation policy which followed national guidance. The emergency department at CGH operates a minor injuries department only from 8pm to 8am. We observed on our visit, people being accommodated overnight in the hospital's emergency department.

No feedback from partners to include in this report

The medicine division had an audit programme to monitor the quality-of-care patients received and took actions to improve the service in response to the audit results.

The trust had an escalation policy which followed national guidance.

Safety and continuity of care was a priority through the person’s care journey at this service. The medical service had safe systems of care and used a nationally recognised assessment tool for the management of deteriorating people. This included directing staff in what actions they needed to take in the event of a deterioration in a patient’s condition

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

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

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

A patient told us that a shortfall in therapists had led to a longer course of treatment

Staff told us there were not enough therapy staff to meet people’s needs. Staff said that delays with patient discharges was due to a lack of community and hospital-based physiotherapist. The trust was in the process of recruiting into these roles. The service did not regularly use agency staff however, they were used in response to changes in patient’s clinical needs requiring more staff support.

Staff told us they received the support they required to deliver safe care through supervision, appraisal and specialist learning support. This was to develop and improve services and where needed, professional revalidation. The hospital employed clinical educators, together with the use of senior clinical staff for training including a rotation onto medical wards to gain experience. Staff took part in multidisciplinary meetings to effectively plan patient care.

Overall, the service had appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that met their needs

The service had safe recruitment practices that ensured all staff, including agency staff were suitably experienced, competent and able to carry out their role.

Recruitment, disciplinary and capability processes were fair and were reviewed to ensure there was no disadvantage based on any specific protected equality characteristic.

Staff received mandatory training appropriate and relevant to their role. However, staff told us on Woodmancote ward there were 15 staff awaiting a place on a catheter course with no places available until the end of the year. This had resulted in only 1 permanent member of staff being competent to catheterise patients.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.