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Inspection report

Date of Inspection: 14 September 2010 and 11 July 2011
Date of Publication: 3 February 2011
Inspection Report published 3 February 2011 PDF | 320.95 KB

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People should be safe from harm from unsafe or unsuitable equipment (outcome 11)

Meeting this standard

We checked that people who use this service

  • Are not at risk of harm from unsafe or unsuitable equipment (medical and non-medical equipment, furnishings or fittings).
  • Benefit from equipment that is comfortable and meets their needs.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 14/09/2010, 11/07/2011, observed how people were being cared for, looked at records of people who use services, talked to staff and talked to people who use services.

Our judgement

While the evidence provided raises issues concerning old equipment and an inadequate replacement budget, the trust has robust measures in place to ensure equipment is serviced and maintained.

Overall, we found that the Churchill Hospital was meeting this essential standard.

User experience

The trust provided an inventory of medical equipment which lists over 12,000 devices that are currently maintained. Generic equipment which is used by many wards and departments is stored in three equipment libraries. Each library has a coordinator who collects used equipment from the wards and ensures that it is clean and working.

There is some evidence that equipment being used at the trust is either lacking or not up-to-date. An independent review of paediatric cardiac services (July 2010) commissioned by the South Central Strategic Health Authority, found that there was continuing reference in clinical governance meetings to lack of equipment. There was also references made to some equipment ‘not being to an up-to-date specification'.

The annual occupational health and manual handling report (2009/10) identified an increase in manual handling incidents. Incidents had increased by 48% on the previous year. The report indicates that this is, in part, due to problems with equipment. The report outlined that the new contractor engaged to service patient hoists had identified that many hoists require replacing. Similarly, there were some hoist fabric slings that did not have a legible safety notice. The report stated that these should therefore be removed from service.

Executive staff ‘walkarounds’ also identified concerns with shortages of general nursing equipment, in particular patient monitoring devices leading to additional added time pressures for nursing staff. Issues related to the length of time to repair medical devices were also raised. This led to problems with lack of available equipment.

The annual report (2009) states that during 2009 there were 492 device related incidents. Two of these were graded red and investigated as serious untoward incidents.

The trust provided evidence to show that there are arrangements in place to identify and manage risks related to equipment. There is a reporting structure in place and a medical devices group that meets bi-monthly. Minutes of this meeting showed examples of decisions being taken in regard to equipment needs and issues being raised and followed up. There is also a medical equipment prioritisation group.

Information provided by the trust indicates that there are over 500 external maintenance contracts. Contracts are only placed with the original equipment suppliers, or with third parties who are able to provide accredited maintenance for that category of device. The trust stated that there are processes in place to ensure that the quality of in-house maintenance is maintained. The engineering department undergoes regular external and internal audit. Clinical engineering staff were reported to receive accredited training prior to working independently on maintaining medical equipment. During our visit, equipment was found to be labelled with stickers to indicate when it was last serviced. This included resuscitation equipment.

Generally staff reported that there was good access to equipment and repairs were completed in a timely manner.

Other evidence