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Provider: Wrightington, Wigan and Leigh NHS Foundation Trust Good

On 9 March 2018, we published a report on how well Wrightington, Wigan and Leigh NHS Foundation Trust uses its resources. The ‘shadow’ rating from this report is below.

Use of resources: Good

We are carrying out checks on locations registered by this provider. We will publish the reports when our checks are complete.

Inspection Summary


Overall summary & rating

Good

Updated 9 March 2018

Our rating of the trust improved. We rated it as good because:

  • We rated safe, effective, caring, responsive and well-led as good. We rated four of the trust’s services at this inspection. In rating the trust we took into account the current ratings of the services not inspected this time.
  • We rated well-led at the trust level as good
  • Our decisions on overall ratings take into account, for example, the relative size of services and we use our professional judgement to reach a fair and balanced rating.
Inspection areas

Safe

Good

Updated 9 March 2018

Our rating of safe went up. We took into account the current ratings of services not inspected this time. We rated safe as good because:

  • The trust had mandatory training in key skills for all staff. Compliance rates across the areas we visited were high.
  • Services managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and in most areas we saw shared lessons with the team and wider services.
  • Staff understood how to safeguard patients from abuse and had completed training on how to recognise and report abuse.
  • In most areas services had appropriate equipment, which was well maintained and ready to use. Areas we visited on the inspection were visibly clean.
  • In most areas services were effectively assessing the risks to patients and taking action.
  • In most areas there were effective processes and systems for the safe management and control of drugs. Patients received the right medication at the right dose at the right time.
  • Staff kept appropriate records of patients’ care and treatment. Records were clear, up-to-date and available to all staff providing care. Although in some areas paper and electronic records were still being used.

However:

  • In urgent and emergency, medicine and maternity there were times when there were gaps in nursing and midwifery staffing.
  • In maternity, the service was not doing everything it could do keep women and their babies safe. Women were being given opioid analgesia without appropriate monitoring, maternity early warning scores were not always completed and there was not resuscitation equipment in every area.

Effective

Good

Updated 9 March 2018

Our rating of effective stayed the same. We took into account the current ratings of services not inspected this time. We rated effective as good because:

  • In most areas the care and treatment was evidence based and provided in line with best practice guidelines.
  • Every service was collecting and monitoring patient outcome data and using the findings to undertake audits and improve clinical practice. Services were participating in local and national clinical audit.
  • Staff had received appraisals and were suitably skilled and qualified to carry out their roles.
  • In every area we saw different staff working well together.
  • In every service patients were given enough food and drink to meet their needs and in most areas pain relief was given in a timely way.
  • Most staff had received training in the Mental Capacity Act 2005 and knew how to support patients who lacked capacity.

However:

  • In maternity, not all care and treatment was in line with national guidance and evidence of effectiveness. The guidelines that were in place were not all clear, in date or reflecting current practice.

Caring

Good

Updated 9 March 2018

Our rating of caring stayed the same. We took into account the current ratings of services not inspected this time. We rated caring as good because:

  • All staff treated patients with compassion, dignity and respect. There were positive interactions between staff and patients.
  • All patients and carers said staff did everything they could to help and support them.
  • Staff involved patients in decisions about their care and treatment. Staff made sure to consider all aspects of a patient’s wellbeing, including the emotional, psychological and social.

Responsive

Good

Updated 9 March 2018

Our rating of responsive stayed the same. We took into account the current ratings of services not inspected this time. We rated responsive as good because:

  • The trust planned and provided services in a way that met the needs of local people.
  • All services took account of patients’ individual needs. The trust worked with partner organisations to support people with additional needs, such as people with learning disabilities and mental health conditions.
  • People could access the service when they need it. In most areas national targets and indicators were met, and in urgent and emergency action was taken to improve performance.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results which were shared with staff.

However:

  • Not every patient was in the most appropriate bed and patients were sometimes moved at night.

Well-led

Good

Updated 9 March 2018

Our rating of well-led went up. We took into account the current ratings of services not inspected this time. We rated well-led as good because:

  • Services had leaders with the right skills and abilities to run the services.
  • The trust had a recently relaunched vision and strategy, which most staff were aware of.
  • In every service there was an open and honest culture. Staff were positive about working for the trust and felt valued.
  • In most areas there were effective governance structures and staff were clear about their roles and accountabilities.
  • Most services had effective systems for identifying and managing risks. Although these were not always updated in medicine.
  • Services engaged with their patients, staff and the public in how services were run and how they could be improved.
  • The trust was committed to improving services and staff across the trust were involved in the quality champion programme.

However:

  • In maternity, the future plans were not embedded into practice and many staff were not aware of them or involved with the plans. Governance structures were not effective and not all risks had been addressed. The service was carrying out limited engagement with the public and had not learnt lessons from previous incidents.
Assessment of the use of resources

Use of resources summary

Good

Updated 9 March 2018