23 November 2021
During a routine inspection
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
We only inspected the surgical core service this time. We rated surgery as good because:
- Managers regularly reviewed and adjusted staffing levels and skill mix to keep patients safe from avoidable harm and to provide the right care and treatment. The service used agency staff and bank staff and gave staff a full induction.
- Staff had access to training in key skills however compliance levels were low due to a pause in training due to the COVD-19 pandemic, staff understood how to protect patients from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and mainly kept good care records. They mainly managed medicines well. The service managed safety incidents well and learned lessons from them.
- Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
- The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
- Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.
However:
- Compliance with mandatory training was low in some areas due to a pause in training due to COVID-19.
- Recruitment and retention of staff remained a challenge for the service.
- Staff did not always keep accurate records around the prescribing and administration of patients’ medicines.
- Patient records were not always stored securely.
- Policies such as the safeguarding adults and children’s policy and the medicines management policy did not always have enough detail or contain any local adjustments.
- Ward areas did not display details for patients on how to make a complaint.
- All Nursing staff should be confident and competent to assess a patients’ capacity.