At our inspection on 19 August 2013 we found control mechanisms were in place for medicines requiring cold storage.
We did not speak to people using the service as part of this inspection because of the nature of the enforcement action we were following up.
We found medicines were administered to patients safely.
We did not speak to people using the service as part of this inspection because of the nature of the compliance actions that we were following up.
We observed nursing staff being polite and respectful, and they did not appear rushed when talking to patients. One person using the service we spoke with said; 'they always do their best to answer my concerns'.
People told us they felt safe in the hospital and that staff were concerned for their welfare. One person said; 'most staff are nice and they really look after me'. They said the hospital was clean and well equipped.
People said they were happy with the arrangements made for their medication. They said they or their carer had been given enough information about their medicines.
We found that people's independence was promoted and that they were involved in planning their treatment and care. Their privacy and dignity were respected. They experienced treatment and care that met their needs, and medical equipment and health records were maintained to support this. However, improvements were needed in the arrangements for the storage and administration of medicines.
The trust submitted the requested information on 01 October 2012. This information demonstrated that the trust had made the requested improvements. The trust was taking forward the recommendations of the consent audit completed at the beginning of 2011, including improving the documentation of benefits and risks in people's notes; and was improving the proportion of staff receiving mental capacity act training. It had taken action to ensure letters were sent to GPs within 10 working days and to reduce the number of delayed transfers of care. It had taken action to reduce the number of complaints about the hospital.
We weren't able to speak to people using the maternity service, but gathered evidence of people's experiences of this service by reviewing the trust's maternity survey. This was carried out for the trust in 2011 by an independent survey contractor, replicating the Care Quality Commission national maternity survey 2010 methodology.
The survey showed there had been improvement between 2010 and 2011 in respondents' experience of the care they received in the following areas: getting the pain relief you wanted during labour; if you'd had an episiotomy, how long after the birth the stitches were done; being treated with kindness and understanding in hospital after the birth of your baby; and rating overall the care you received after the birth.
There were slight falls in positive responses in the following areas: feeling that midwives and carers gave you active support.
Respondents' rating of their experience during their labour and birth remained the same and was positive.
We gathered evidence of people's experiences of the service by reviewing the trust's maternity survey 2011. This was carried out for the trust by an independent survey contractor, replicating the Care Quality Commission national maternity survey 2010 methodology.
The survey showed there had been improvement between 2010 and 2011 in respondents' experience of the care they received in the following areas: finding a position that made you comfortable during labour; getting the pain relief you wanted during labour; if you'd had an episiotomy, how long after the birth the stitches were done; being treated with kindness and understanding in hospital after the birth of your baby; and rating overall the care you received after the birth.
There were slight falls in positive responses in the following areas: length of stay in hospital being about right; and feeling that midwives and carers gave you active support.
Respondents' rating of their care during their labour and birth remained the same and was positive.
Patients in the Day Surgery Unit (DSU) told us that staff responded to their needs promptly and they were given pain killers as required and monitored after their operation.
Patients in the Rapid Access Chest Pain Clinic (RACPU) told us that they were impressed with the service; they were referred by their GP and seen within 9 days and had all necessary test completed in one visit.
Patients in the phlebotomy clinic told us that they had experienced long delays waiting to have blood tests taken.
Most of the patients told us that the risks and alternative to having an operation had been discussed with them by the doctor who was going to carry out the procedure.
Patients told us they had received good care and treatment and that staff explained their treatment to them, treated them with respect and overall provided good care.
One patient commented that she was a very private person and staff were sensitive to her needs and maintained her privacy.
Patients we spoke to felt involved in their care and some of the patients on the stroke ward felt they were involved in goal setting; although some patients felt they wanted to leave the decisions to the care professionals. We were told by some patients that the staff were very good at providing explanations and information, although one patient felt they were task rather than patient orientated. All the patients we spoke to felt staff explained what they were going to do and asked them prior to helping.
Most patients we spoke to felt that call bells were responded to in a timely manner although some commented that it's was more variable at night and at week-ends, dependent on staffing levels.
Patients we spoke to felt the mealtimes were relaxed and organised and that help was available if required and that staff gave assistance when required. Patients we spoke to were not offered hand washing facilities prior to eating and one patient told me she used the hand gel; another patient said she had to ask to be sat out of bed for lunch.
One patient told us that she now looks forward to her mealtime and there is always enough choice of food available.
Overall, patients were generally happy with the food quality and quantity provided and the help given by staff.
People and their partners felt they had received care that was based on their individual needs and appropriate planning, treatment and support had been given throughout their pregnancy and birth of their babies.
People we spoke to told us that the midwifery teams which include midwifery support workers had provided help and assistance to them to enable them to breast feed their babies People we spoke to told us that they received very good care in the Day Assessment Unit; however, they reported a lack of continuity in antenatal care with different midwives providing care at each visit.