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Watford General Hospital Requires improvement

All reports

Inspection report

Date of Inspection: 20, 21 November 2014
Date of Publication: 21 May 2015
Inspection Report published 21 May 2015 PDF

Overview

Inspection carried out on 20, 21 November 2014

During a routine inspection

We spoke to 29 patients who used the service, 40 members of staff and members of the executive team. We looked at the personal care and treatment records of 21 people who used the service. We observed how people were being cared for and talked with patients using the service. We talked with staff, and reviewed information given to us by the provider. We were accompanied by two specialist advisors. Following the visit, we asked the trust to provide further information in order that a judgement could be made: this information was received at the end of December 2014.

Safety

We found that learning from incidents was not always shared and that safeguarding procedures were not robust. Nurse staffing levels were affected by the high level of staff vacancies, despite on-going recruitment significant pressures on staff were evident in the maternity service. Mandatory training for staff was below the trust�s targets. Infection control procedures were effective at the time of our inspection. Record keeping within the hospital had improved since our last inspection.

Effective

Overall mortality rates for the trust had improved and there was some evidence of review of care pathways to give improved outcomes for patients. We found poor nursing care planning in some instances and the care and treatment given to patients was not always meeting their needs. The trust was behind trajectory for staff appraisals at the time of the inspection and most staff did not receive formal supervision on a regular basis. We saw good multi-disciplinary working between different professionals. We found variable levels of staff understanding and recording of patients� mental capacity to make decisions. There were concerns about the hospital�s application of the Deprivation of Liberty safeguards (DoLS).

Caring

Overall, staff were very kind and compassionate in their approach to patient care and the hospital was seeking meaningful feedback from patients and their advocates. Patients� dignity was respected.

Responsive

This domain was not assessed as part of this inspection.

Well led

Whilst the trust had made significant improvements in its governance and risk management processes, we found it was not yet fully embedded throughout the staff team at the hospital. A series of patient safety initiatives had been implemented to address the concerns we had found at our last inspection, these initiatives were in use at the time of the inspection.