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Inspection Summary


Overall summary & rating

Good

Updated 3 July 2018

Our rating of services stayed the same. We rated it them as good

A summary of this hospital appears in the overall summary above.

Inspection areas

Safe

Good

Updated 3 July 2018

Effective

Good

Updated 3 July 2018

Caring

Good

Updated 3 July 2018

Responsive

Good

Updated 3 July 2018

Well-led

Good

Updated 3 July 2018

Checks on specific services

Outpatients and diagnostic imaging

Good

Updated 27 March 2015

In April 2014 the outpatient department could show a good service for patients following surgery or treatments. The safety quality dashboard demonstrated good performance for managing patient risks across the hospital. The consistent feedback from patients and carers was that they would recommend the hospital to family and friends.

However, County Hospital Louth outpatient service required improvement as mandatory training provision for staff was poor especially in key risk areas, such as: safeguarding, health and safety management, basic life support, recognising the deteriorating patient and mental capacity assessment practices. This could impact on patient safety and requires improvement.

In March 2015 staff confirmed they received feedback from any incidents they raised and lessons were learned. Mandatory training levels for staff had improved, regular health and safety meetings were in place and action plans developed to address concerns. However, simulation training for a collapsed patient had yet to be undertaken.

We found in April 2014 there was a lack of shared vision and strategy with the staff to assure them of a sustainable future. More visible leadership was required to ensure that County Hospital Louth outpatient services were well-led. Staff noted there was a disconnect between leadership at board-level and frontline clinical teams in County Hospital Louth. Staff engagement was lacking and formal communication practices were limited which resulted in staff not always receiving feedback or being fully aware of the bigger picture or future plans.

We saw leadership had improved in March 2015 with the appointment of a matron for County Hospital Louth. Staff felt better connected with the rest of the hospital sites in the trust although work was needed to embed formal governance processes in the department.

Surgery

Good

Updated 3 July 2018

Our rating of the service stayed the same. We rated as good because:

  • The service had a positive incident reporting culture demonstrating, learning and sharing both locally and across the trust.
  • There was a robust system for pre-operative assessment with clear admission criteria, comprehensive infection control and prevention and risk assessments for all patients.
  • There was access to equipment, including emergency equipment with in-house medical physics support.
  • Staff understood their roles and responsibilities under the Mental Health Act 1983, and the Mental Capacity Act 2005.
  • Risks to people were assessed, managed, and monitored on a day-to-day basis.
  • Surgical services at County Hospital Louth provided care to patients in line with local and national guidance.
  • Staff were competent and appropriately trained to undertake the role for which they were employed, had equal opportunities for professional development and were up to date with annual appraisals.
  • The trust had a five-year strategy for all clinical services for 2014 to 2019 to support the delivery of good quality patient care. This underpinned trust values.
  • Staff were aware of trust values which were displayed within departments and told us they felt valued in their work.

However, we also found:

  • Some items of equipment were out of date for servicing schedules. This was escalated and rectified at the time of the inspection.
  • Surgical services had identified a worse than England average referral to treatment time (RTT). However, managers were taking active steps to monitor and manage delays with an action plan in place.