Nottingham City Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm. We found that staff knew how to report incidents and some learning from incidents occurred. However, we found that staff were not always protected from abuse from the public. Staff were aware of the actions to take if they were concerned for the patient’s safety. Staff controlled access to and from the ward areas despite the entrance being a distance from the nursing station.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

During this inspection we only assessed limited aspects of this quality statement please see the previous report for a full assessment of the quality statement. The rating is based on our previous assessments.

Lessons were not always learnt to continually identify and embed good practice. However, staff listened to concerns about safety and investigated and reported safety events.

Staff knew what incidents to report and how to report them. Staff raised concerns and reported incidents and near misses in line with trust policy. Staff could describe what incidents were reportable and how to use the electronic reporting system. Staff did not report all events of aggression and violence from patients and their significant others as they were not assured action would be taken by the trust. Staff had training from the police service about physical violence. It was unclear from staff or the supporting evidence provided if they had had training on de-escalation techniques or other strategies to manage the aggressive behaviours. The training by the police had been hospital wide training, and it was unclear how many midwives had attended this training.

The ward manager on the postnatal ward stated that there was a zero tolerance of poor behaviour. If on duty at the time of any incident she would attend to support the midwives. Senior staff stated that a hot debrief would occur and they would look at all aspects that may have influenced the aggression. Senior staff felt that there had been some learning from these incidents. They were aware that body cameras were going to be available for staff to help protect them in violent and aggressive situations. However, staff were awaiting a training date for this.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

During this inspection we only assessed limited aspects of this quality statement please see the previous report for a full assessment of the quality statement. The rating is based on our previous assessments.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. Staff concentrated on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We saw evidence that baby abduction drills were completed. The ward manager talked us through how this worked in practice. They chose an empty bed/ bay and walked onto the ward and stated a baby from this area had gone missing. Staff then followed the drill procedure. A discussion took place where staff felt something could have gone better. Security tags were not available on this site. Only staff on Lawrence ward (1 ward out of 3 we spoke visited) could remember when the last baby abduction drill had occurred. The ward manager had a plan to undertake this every July.

The nursing station had direct line of sight of the ward door which was locked. Everyone without a pass had to buzz the desk to be let in or out of the ward area. However, the nurses’ station was some distance from the door and people leaving were not checked prior to leaving. Doors were slow to close behind people entering and exiting the ward area. However, we were challenged by a team member and asked to buzz for entry rather than tailgating them into the ward.

Ward staff could give examples of how to protect women from harassment and discrimination, including those with protected characteristics under the Equality Act. Staff understood the importance of supporting equality and diversity and ensuring care and treatment was provided in accordance with the Act.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.