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Grantham and District Hospital Good

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Inspection report

Date of Inspection: 24, 25 February 2014
Date of Publication: 2 April 2014
Inspection Report published 02 April 2014 PDF | 94.14 KB

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 24 February 2014 and 25 February 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

Since our last visit all the staff we spoke with had received an appraisal or had one booked to attend. Records were seen to confirm these had taken place. Monitoring reports were sent to the board on a monthly basis.

All staff said they had access to mandatory training and any additional training depending on the service being able to release them. Each ward area had a clinical educator role. We spoke with three of them. They also confirmed releasing staff for specific pieces of training could be an issue.

Supervision was something which was not done on a planned programme. However staff told us they could speak to their line managers at any time. The supervision policy was due to be reviewed in November 2012, so was now out of date and the appraisal policy is to be reviewed in July 2014. Matrons told us they did have one to one sessions with their line managers and showed us the form used for each session.

Two new staff told us they had received an induction and shadowed staff when first working on the wards. Two other staff told us they had received preceptorship training, after they had initially qualified. This is a form of mentoring for newly qualified nursing staff.

Staff on some wards had been trained in specific tasks to aid the health and welfare of patients. This included training in lung biopsy, taking blood and draining fluid from a patient's abdomen. Staff were also encouraged to visit other units for ideas. This had worked well in the day unit when staff had visited other similar units and were now looking at the information gathered.

One ward was experiencing a gap in the knowledge and experience of some surgical nursing staff due to recent changes in the types of conditions which patients admitted to the ward were diagnosed with. The ward manager was monitoring the situation and was looking at skill mix in each. The training matrix was being merged, which we saw on the computer. Staff told us this would then give a better overview of staff skills.

Patients told us they had confidence in the staff. One patient said, "Excellent care, everything was explained to me and I was made comfortable."

Doctors we spoke with told us they were supported by their line managers. They had received appraisals and had daily meetings with the consultant to discuss patients. They said they could raise any topic and felt their opinion was valued.

Health care support workers told us they had taken part in all mandatory training. They told us they had been encouraged to take part in the National Vocational Qualifications programme (NVQ). Some also told us they were looking at completing extended roles in areas such as cannulation and phlebotomy.

Ward managers had recently completed a ward leadership programme. They told us it had been really good. One staff member stated it had been, "Inspirational."

One of the senior managers said money had been set aside to develop clinical nurse specialist posts in areas such has diabetes, respiratory and cardiology nursing. They hoped this would aid training of staff.

Staff were aware that members of the board visited. This had been received with mixed views of staff we spoke with. Some said it was their time to get a view across. One staff member said, "I'll always speak with them, otherwise you can't complain your voice isn't being heard." Another staff member felt the visits had, "Tailed off."

The provider may wish to note that staff were generally not aware of the Ward Health check. We were told by a senior manager this was still under development and would be going to the Quality Governance Committee in March 2014. We have asked the trust to keep us informed of when this will be fully operational.