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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 be cared for in safe and accessible surroundings that support their health and welfare (outcome 10)

Meeting this standard

We checked that people who use this service

  • Are in safe, accessible surroundings that promote their wellbeing.

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

Overall we found that the provider is compliant with this outcome but improvements are needed.

We have minor concerns that many of the wards providing care for older people are not environments conducive to modern day delivery of clinical care. We are mindful that the trust fully acknowledges these concerns and is working towards providing both short term solutions together with long term redevelopment of the site.

Some facilities provided within these wards were not found to be maintained in good working order. Bathrooms and shower rooms which are currently out of commission need to be available for patients.

User experience

People we spoke with during our visit including patients and relatives told us that they were generally satisfied with the environment which they described as “reasonably comfortable” and “safe”.

However, the temperature on some of the wards that we visited and the lack of space were recurring issues with many people (including staff). We received various comments about how it was always “far too warm” and the heat was sometimes “overbearing” and there was “no air”.

Many people also spoke of how cramped certain areas of the wards were, particularly when in bays the beds were so close together that it had an impact on people’s privacy and their personal space. We were told by one patient “There’s just no room between the beds. You can hardly get a chair in the gap and when it’s busy you can hardly move or hear your self speak”.

One person accommodated on Vallance ward said he found it “a bit crowded” and a lady on Jowers said “the staff are wonderful and work so hard in such cramped conditions”.

Other evidence

During the visit we were aware that this hospital is accommodated in a range of buildings over a large site and staff battle continually to deliver care in an environment that in areas is not conducive to modern day delivery of clinical care. In particular the Barry Building which is the oldest building on the site and requires a high level of maintenance poses a constant challenge for the organisation. The trust is maintaining the building to a reasonable standard and it was found to be clean throughout. However, the numbers of people being accommodated means that every area is utilised for the delivery of clinical and nursing care and there is insufficient communal space. The wards are cramped and the environment gives the impression of being over crowded.

It is recognised that the hospital is undergoing a programme of re-development with continual redecoration and refurbishment to address the challenges of the increased population it treats.

We visited several wards in the Barry Building including Vallance ward, which is an elderly medicine ward with 19 beds. Staff told us that one bed on the ward had been removed as there was not enough space in the bay. Nursing and medical staff told us that the ward was not fit for purpose. The ward was overcrowded, with only space for one chair in between beds. In some cases the chair was behind a pillar so there was no space for a visitor’s chair and it would have been very difficult to get any equipment, such as a wheelchair, next to the bed.

The nurse’s station was very busy, with a lot of people coming and going, which meant that the environment was very noisy and lacking in privacy for the people whose beds were in the bay overlooked by the nurse’s station. Two beds were right next to the nurse’s station and effectively in a corridor, providing very limited privacy unless the curtains were drawn around the bed. Another bed was in a small recess behind the nurse’s station, directly outside the isolation room. The ward sister told us that the isolation room was not fit for purpose because of this, but that patients would be immediately transferred to the hospital’s isolation ward if a diagnosis requiring isolation was confirmed.

The ward had no day room, which denied people the opportunity for people to socialise or for their independence to be promoted through eating together at a table. When we sampled two care plans we saw that the people had been resident on this ward for longer than 10 days. The lack of any communal areas for sitting or having meals meant that these elderly people could only sit in the very confined space next to their bed day after day with little or no social interaction or stimulation.

The ward had insufficient storage facilities, although the ward manager told us that a toilet had recently been removed so the room could be used for storage. We saw several cases where equipment was causing an obstruction; for example there were three commodes in the store cupboard preventing access to the shelves of supplies which would be in regular use; and there was a clinical waste bin in the middle of the floor in the clinical room. The bathroom had a notice on the door saying that equipment must not be left in the bathroom, but there was a weighing chair in the room which had to be removed before we were able to enter.

Whilst we were on this ward we observed an incident where due to the lack of space between beds on the ward staff assisting one person accidentally knocked over a jug of water on a bedside table at the next bed along.

We found similar problems when we visited another elderly care ward called Jowers. We found some of the bathing facilities were out of use. One walk in shower was not being used and nursing staff told us this was because it was not suitable to use with elderly patients as they needed to step down into the shower and the room itself was too small to accommodate any moving and handling equipment or for staff to safely assist patients w