Archived: Bridgewater CHCFT Newton Community Hospital

Updated 17 April 2014

Newton Community Hospital is a newly built facility offering both inpatient and outpatient services. The hospital was built to replace an older nursing home and community facility and was previously managed by St Helens Primary Care Trust.

The inpatient unit was supported by a multidisciplinary group of staff employed through various organisations including the local authority, 5 Boroughs Partnership NHS Foundation Trust, Bridgewater Community Healthcare NHS Trust and local GPs. The inpatient unit had 30 beds and primarily provided intermediate care either as a step up facility to reduce the need for an admission to an acute hospital or as a step down facility following discharge from hospital.

The outpatient facility supports the local community and surrounding areas with consultant or nurse led clinics and minor surgery.

Updated 17 April 2014

Newton Community Hospital is a newly built facility offering both inpatient and outpatient services. It was built to replace an older nursing home and community facility and was previously managed by St Helens Primary Care Trust.

The inpatient unit was supported by a multidisciplinary group of staff employed through various organisations including the local authority, 5 Boroughs Partnership NHS Foundation Trust, Bridgewater Community Healthcare NHS Trust and local GPs. The inpatient unit had 30 beds and primarily provided intermediate care either as a step-up facility to reduce the need for an admission to an acute hospital or as a step-down facility following discharge from hospital.

The outpatient facility supported the local community and surrounding areas with consultant or nurse led clinics. The facility was managed by an outpatient’s manager and supported by nurses, reception and, administration staff and medical secretaries. Clinics included cardiac teams, dermatology, ear, nose and throat and a newly formed skin cancer clinic.

Care was generally safe. Evidence showed that staff reported information through the national safety thermometer tool and internal quality monitoring. Incidents were recorded on the trust’s Ulysses system and the ward manager completed risk assessment and risk management plans. We identified a range of errors and weaknesses in risk and quality reporting and action taken following the identification of risks which could impact on the trust overall assurance of the unit. We judged this to be a breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. However staff had implemented a range of developments at the hospital over the last year that had helped to improve the safety of care, for example the development of tissue viability assessments.

Staff delivered care using evidence-based guidance through standard operating procedures. Discharge planning was effective and the multidisciplinary team (MDT) worked with staff in the community to help prevent hospital admission, and to support patients after they are discharged.

Patients commented on the caring and compassionate approach of staff and that patients were involved in decisions about their care. Discharge planning started when patients were admitted, and families were fully involved. The team had daily multidisciplinary meetings to ensure the planned care remained appropriate.

While it wasn’t clear what the long term vision for Newton Hospital was, at ward level the multidisciplinary teams were committed to meeting the needs of the people who used the inpatient unit. Comprehensive assessments were completed by each member of the team and progress was discussed within the daily multidisciplinary team meetings. However, the lack of clarity regarding the long-term purpose of the hospital was having a detrimental effect upon the staff who worked there.

Updated 17 April 2014

Staff were dedicated to providing a high quality service to the patients on the ward at Newton Community Hospital. This was reflected in the comments made by patients and their relatives. Services were tailored to meet the needs of patients requiring intermediate care. The service also included post discharge outreach support of up to two weeks to reduce the risk of further readmission.

Care was generally safe. Evidence showed that staff reported information through the national safety thermometer tool and internal quality monitoring. Incidents were recorded on the trust’s Ulysses system and the ward manager completed risk assessment and risk management plans. We identified a range of errors and weaknesses in risk and quality reporting and action taken following the identification of risks which could impact on the trusts overall assurance of the unit, for example data reporting errors in the quality report. However staff had implemented a range of developments at the hospital over the last year that had helped to improve the safety of care, for example the development of tissue viability assessments.

Patient risks were assessed and plans developed to reduce those risks. There was a daily multidisciplinary review of patient risks and progress to make sure that the planned care remained relevant and patients were making suitable progress.

Care was effective and around 70% of patients were discharged back to their own home. Staff had developed evidence based guidance and standard operating procedures that all members of the multidisciplinary team used. However some of the generic trust guidelines would benefit from being improved to ensure they met the needs of an inpatient unit rather than community service.

Patients and their relatives commented favourably on the care they or their relative received. We saw staff being respectful towards patients, and ensuing that patients were treated with dignity. Patients were involved in decisions about their care, were part of the regular multidisciplinary team meetings, and consideration of the families needs was also apparent.

There had been a number of changes at the hospital over the past year, following an independent review that the trust had commissioned due to concerns about safety and quality at the hospital. The unit had appointed a new manager who was providing good leadership and direction for the staff; and who had developed local working guidance and policy to ensure staff received the appropriate training and support, for example pressure area care management and medicines management. However, clarity about the long term vision of the unit was required as staff do not currently feel included with developing and defining the service.