- Community healthcare service
Archived: Shire Hill Intermediate Care Unit
Important:
This service was previously managed by a different provider - see old profile
All Inspections
18th November 2015
During an inspection looking at part of the service
We undertook this unannounced inspection of Shire Hill Intermediate Care Unit as a follow up to our previous inspection which took place on 22nd September 2015. The inspection we undertook on 22nd September was in response to concerns that were raised with us. Shire Hill Intermediate Care Unit is a 36 bedded unit situated in Glossop and offers inpatient rehabilitation services to patients over the age of 18 in the Tameside and Glossop areas. Care is delivered over two inpatient units; the Ludworth and Charlesworth units. These units are situated in the same building on two separate floors.
We inspected the unit during the evening of 18th November 2015. We visited the following areas:
- Ludworth Unit
- Charlesworth Unit
Our key findings were as follows:
We found that patients at Shire Hill Intermediate Care Unit were receiving timely and appropriate care during our visit. Nurse staffing levels had improved since our last inspection. There were still periods of understaffing however we found evidence that senior managers had taken appropriate steps to try to address periods of understaffing. These steps included offering staff that work at the unit extra shifts and the increased use of agency staff to mitigate last minute absences.
During our last inspection we found evidence that although an early warning score system was used on both units to identify patients who were at risk of deterioration, staff were not applying this system correctly in some cases. During this follow up inspection we found that staff were still not applying the system in some cases and were not undertaking observations of patients at the correct frequency.
During our last inspection we found that patient records were not stored securely and some records lacked important information. During this follow up inspection we found that patient’s records were securely stored in a locked room. We also found that some records still lacked important information and contained some discrepancies.
During our last inspection we found that some patients experienced a delay in receiving their medication including pain relief and the section regarding the recording of allergies was not completed in some records. During this follow up inspection we found that patients were receiving their medications in a timely way and all medication charts reviewed, contained the appropriate allergy information.
There were still some issues of concern on both units regarding the standard of checks made on equipment.
Infection control processes and procedures were in place.
Medical staffing on the unit was adequate to ensure patients received timely and safe care. Staff were able to access medical advice when they needed to.
Importantly, the trust should:
- Continue to ensure that staff undertake and record patient observations consistently and accurately.
- Ensure that equipment is checked thoroughly on a regular basis.
- Remove out of date resuscitation guidance and policies and ensure staff have access to up to date guidelines and policies on resuscitation.
Professor Sir Mike Richards
Chief Inspector of Hospitals
22nd September 2015
During an inspection looking at part of the service
We undertook this unannounced inspection of Shire Hill Intermediate Care Unit in response to concerns that were rasied with us. Shire Hill Intermediate Care Unit is a 36 bedded unit situated in Glossop and offers inpatient rehabilitation services to patients over the age of 18 in the Tameside and Glossop areas. Care is delivered over two inpatient units; the Ludworth and Charlesworth units. These units are situated in the same building on two separate floors.
The Care Quality Commission undertook this focussed inspection in response to concerns that were reported to us about staffing levels, particularly at night time. We inspected the unit during the evening of 22nd September 2015. We visited the following areas:
-
Ludworth Unit
-
Charlesworth Unit
Our key findings were as follows:
We found that patients at Shire Hill Intermediate Care Unit were not receiving timely and appropriate care at all times. Nurse staffing levels at times were not sufficient on both units to ensure patients were cared for appropriately. There were periods of understaffing that senior managers did not address adequately or quickly and the risks associated with these periods of understaffing were not fully recognised or managed. The issues relating to understaffing had a negative impact on patient care and experience.
We found that staff completed appropriate risk assessments for patients in some cases. There was an early warning score system used on both units to identify patients who were at risk of deterioration. However, staff had not applied this system correctly in some cases and this had led to some patients not receiving timely review by a doctor or closer observation.
Staff completed records in legible and clear handwriting. However, patient records were not stored securely and some records lacked important information and contained some discrepancies.
Medicines were managed safely on both units and staff made appropriate checks when administering medication. Some patients experienced a delay in receiving their medication including pain relief and the section regarding the recording of allergies was not completed in some records.
The facilities were visibly clean, free from clutter and fit for purpose. On both units, we found some issues of concern with the standard of checks made on equipment. The unit displayed safety calendars, which gave information on pressure ulcers and falls. This information was displayed on the wall at the entrance to each unit and in the staff office on each unit. Incident reporting systems were adequate and staff were able to use the incident reporting system effectively.
Infection control processes and procedures were in place, which helped safeguard patients from avoidable infections.
Medical staffing on the unit was adequate to ensure patients received timely and safe care. Staff were able to access medical advice when they needed to.
Importantly, the trust must:
- Ensure that safe staffing levels are provided on both units at all times.
- Ensure that staff undertake and record patient observations consistently and accurately.
Professor Sir Mike Richards
Chief Inspector of Hospitals