12 August & 19 August 2021
During a routine inspection
Our rating of this location improved. We rated it as good because:
- Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
- The Hospital controlled infection risk effectively and introduced enhanced precautions since the beginning of the COVID-19 pandemic.
- Staff provided good care and treatment and gave patients pain relief when they needed it.
- Managers monitored the effectiveness of the service and made sure staff were competent.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff provided emotional support to patients and their families.
- The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers and people could access services when they needed them.
- Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.
- Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities. The hospital engaged well with patients to plan and manage services and all staff were committed to improving services continually.
However:
- The service was not doing all it could to remove or minimise risks to patients. Nationally recognised tools and guidance were not always used in a way that minimised risk. The World Health Organisation (WHO) safety checklist for surgery was not always completed in a way that kept people safe. When changes were made in the order of the theatre list, it was not always updated in line with best practice. Staff did not always complete the anaesthetic machine logbook.
- Patient notes were not always comprehensive, and information was not always easy to locate.
- National early warning scores (NEWS) were not always calculated accurately and there was a risk, patients might not be escalated appropriately.
- Medicines were not always stored securely in theatres.
- There was variable understanding and learning from never events and incidents, that occurred both within the service and in other organisations. Not all staff were able to articulate what had been learnt from incidents they described or how processes had changed to prevent incidents from happening again.
- Staff across surgical services thought multidisciplinary team working could improve in pre-operative assessment. Staff did not always agree nor feel supported on admission criteria and there was room for improvement in learning from patient cancellations.