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All reports

Inspection report

Date of Inspection: 25 July 2013
Date of Publication: 21 August 2013
Inspection Report published 21 August 2013 PDF | 69.55 KB

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 25 July 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

There was not always enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

Moseley Hall Hospital web site describes the care provided on wards five and six as being ‘sub-acute’ care. Sub-acute care is inpatient care designed for someone who has an acute illness, injury or flare-up of a known condition. Sub-acute care and treatment is specific and is generally delivered immediately after, or instead of, an acute hospital admission. As a result of the nature of care provision people receiving care on both wards had a range of conditions, illnesses and needs. Some people required minimal support to regain physical functioning, whilst others required a high level of care, support and reassurance.

We assessed this outcome area in January 2013 and found non-compliance which we judged was having a minor impact on people using the service at that time. We undertook this follow up inspection to find out if improvements had been made. Overall, we found that some improvements had been made but more were needed.

During this inspection we re-looked at concerns that we had found previously such as admission processes. We found that some improvements had been made. One staff member said, “Staff are usually delegated to deal with admissions which has made things better”. We asked all of the people we spoke with about their experience of their admission to the ward. No one told us of a poor experience at that time. One person told us, “I was greeted and made to feel welcome”. This showed that the trust had taken action which had given people more assurance that they would have the time and attention they required during their admission.

As with our previous inspection a number of people told us that they did not know why they were in hospital, how long they would be there, or what was happening regarding their care. However, other people were able to give us a good account of why they were in hospital and what plans had been made for them. We saw that some action had been taken by the trust to improve the communication systems between staff, people using the service and their relatives. We saw that notices were on display giving information about what people should do if they felt that they did not know what was happening regarding their care. A senior manager for the trust told us that they had identified that evidencing communication had been a problem, particularly for those people who may have a poor memory, in that they may have been given information by staff but had forgotten. The senior manager for the trust told us that audits had been undertaken to make sure that conversations with people and their relatives were documented. They told us that if situations occurred then there would be a record to confirm what people had been informed of. This showed that the trust had taken action to promote better communications between staff, people using the service and their relatives so that they were better informed about their individual situations.

Documentary evidence provided by the trust and all staff we spoke with confirmed that recruitment had taken place and was still on-going. We have also been provided with evidence to confirm that interviews are due to take place in August 2013 with a view of appointing into all remaining vacant posts on ward six. We were told that nine new staff had been appointed but as their pre-employment checks were still being carried out they had not yet started work. One staff member confirmed this. They said, “I work on the bank but I have been successful in getting a permanent job. I am awaiting my start date”. The majority of staff we spoke with told us that there had been some improvement with staffing levels. This showed that the trust had taken action and were taking further action to employ permanent staff to provide a more consistent service to people.

We acknowledge that on our inspection day ward six experienced an unusual situation as three of the seven staff due to work on that ward had, for different reasons, not attended work that day. One staff member said, “