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CQC carried out a period of listening activity at Brighton and Sussex University Hospitals NHS Trust in December 2013 and January 2014. The report from that exercise, which informed our inspection in May 2014, is available below.

All reports

Inspection report

Date of Inspection: 5 July 2011
Date of Publication: 26 July 2011
Inspection Report published 26 July 2011 PDF | 154.43 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 05/07/2011, checked the provider's records, observed how people were being cared for, looked at records of people who use services, reviewed information from people who use the service, talked to staff and talked to people who use services.

Our judgement

We observed a great deal of very good care being provided across most wards and departments at the hospital. Patients and relatives talked about staff being kind, attentive and helpful. We saw staff who treated people well, who worked hard to ensure that patients needs were met and who were committed to high standards.

We saw in the main that patient records reflected that clinical care was well documented, however, there were examples in some wards, particularly those caring for elderly patients where personal care plans and risk assessments fell short of the required standard. This meant that peoples’ needs were either not being fully met or recorded appropriately.

Overall, whilst recognising that most people receive good care we judge this hospital to be compliant with this outcome but to maintain this, improvements are needed.

User experience

During our visit we received positive comments from patients and relatives that we spoke to across all areas of the hospital. We were told by one patient that “the staff are all so kind and friendly and the care they provide is second to none”. Another told us that “we feel very involved with the hospital and we are kept informed about what is happening”.

Patients we spoke with in A&E were happy with the treatment and support they were receiving. One patient and their relative told us that they visited the hospital on a regular basis for treatment as an outpatient and that the care and treatment they had received was second to none. They said that they had no complaints what so ever about the treatment and care received. Other patients had similar experiences and said they felt the treatment they had received was good.

We spoke with patients on Jower Ward and on Vallance ward who said they were happy with the treatment they had received and had been given really good care. One patient told us that when they used the call bell, a nurse came straight away, and that when they needed pain relief staff got the medication quickly. This was the same during the night. The patient also said that staff came round regularly and asked if everything was okay and had been given water for washing and had had a shower that day. We asked this person if anything could have been improved, and they told us that it was cold on the ward at night as the window was open, although they had been given extra blankets.

A patient on Lewes ward told us that all their needs were met and that nurses came quickly when they were needed. They said “the nurses always have a smile”. We asked if anything could be improved and they couldn’t think of anything.

A relative whose wife had passed away in the Acute Medical Unit wrote directly to the unit and thanked staff for the “tender loving care they had given his wife, treating her gently and despite the fact that she was unconscious, talking to her and explaining everything they were going to do for her before they did it”. He said that staff in this unit had “made the unbearable bearable” and he would never forget their kindness.

Other evidence

During our visit we asked to have a tour of the Accident and Emergency department (A&E) and were able to track the patient journey through the two entrances which accommodate self presenting patients and those brought in by ambulance.

The initial reception area for patients who present themselves at A&E records the patients’ arrival and then directs them to the waiting room for assessment by a Nurse Practitioner in one of eight consulting rooms. These consulting rooms were clean tidy and fully equipped with locked drugs cabinets, computer terminals and basic treatment equipment. Patients have their immediate needs assessed by the Nurse Practitioner and a basic plan of care is initiated. Their details are entered onto the ‘Symphony’ tracking system which facilitates all further information regarding their patient journey and any care/treatment received by all relevant departments. We were able to see how patients are tracked and their progress documented at all stages of their care. From here patients are then moved to the second waiting area to await further attention, treatment or investigation. The A&E unit is equipped with its own imaging facility which reduces the waiting time for patients who require x-rays.

In both waiting areas we observed notices offering the services of chaperones, advocates, dementia link nurses and translating services. Wall dispensers were full of leaflets giving information about a range of common injuries and conditions such as burns, whiplash, sprains etc. These were freely available for patients to take away with them. Staff told us that patients are always given the appropriate information about their injury or condition when leaving the hospital. The Assistant Chief Nurse explained to us how these leaflets were designed and reviewed by the nursing team to ensure they were up to date and reflecting current best practice. We were told that the trust also has a Carer and Patient Information Group which consistently reviews patient information to ensure that it is an appropriate format. Leaflets are translated into other languages if required.

A separate paediatric waiting area is provided with a large fish tank which we were told promotes a calm atmosphere in the area for the children. Appropriate leaflets specifically written for children were displayed. 24 hour immediate access to paediatric consultants is available from the assessment unit in the Royal Alexandra Children’s Hospital which is also located on site. The matron for paediatrics undertook an audit of parents and children’s experiences in A&E in February 2011 which supported the trusts view that this paediatric facility falls short of current best practice and a dedicated children’s A&E dept is due to open in the children’s hospital later in 2011.

At the time of our visit the resuscitation area was not being used and we were able to review fully the range of equipment in place. The area was clean, very well organised and although the bays were challenging in size best use of space had been organised by the staff. One bay which was set aside for the treatment of paediatrics was well equipped and of particular note was the colour coded system of emergency grab bags coded according to age and approximate weight of child. These were prominently displayed and easily accessible to staff.

Patients arriving into A&E via ambulance and needing emergency treatment are delivered and handed over at the main desk located within the treatment area. It was explained to us how the unit is now trialling a system called Patient Assessment Team (PAT) which receive the patient immediately they enter the unit from the ambulance crew whilst receiving valuable handover information concerning the patient’s condition. Patients are then assessed and treated in order of priority rather than strictly in the order they arrive at the department either by ambulance or self referral.

In the main treatment area of the A&E department the Matron took time to expl