Sheppey Community Hospital

Updated 19 October 2022

Sheppey Community Hospital is one of four locations within the North Kent business unit under HCRG Care Services Limited, who are an independent healthcare provider with over 5,000 staff nationally working in partnership with the NHS and local authorities.

Sheppey Community Hospital provides community adults services across the Swale boroughs in Kent, which align with the local Health and Care Partnership. After more than 10 years as part of the Virgin Group, Virgin Care rebranded as HCRG Care Services Limited in 2021 and was acquired by Twenty20 Capital.

The service registered with the Care Quality Commission in 2016. They are registered to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Nursing care

Sheppey Community Hospital provides the following core services:

• Community health services for adults
• Community inpatient service

The community health services for adults operated across the whole of Swale area. They provided care and treatment for patients in their own homes and in clinics.

The teams at Sheppey Community Hospital include:

• Speech and Language Therapy (SALT) teams worked virtually or in the community and clinics were held on demand. The service was available form 8.30am to 4.30pm Mondays to Fridays.
• Rapid response service that worked seven days a week 8am to 8pm.
• Intermediate care team that worked Monday to Friday 8am to 6pm. The rapid early therapist worked form the office from 8am.
• Community Nursing and Night Service that works 24 hours seven days a week. The Community nursing teams worked from 8am to 8pm and the night service worked from 8pm to 8am working in the community and responding to emergency calls.
• Other services such as community cardiology, community matron service, community diabetes service and community respiratory service provided day clinics on different days and times in the week.

The community inpatient service, Harty ward, is a 22-bed rehabilitation ward. At the time of the inspection the ward had 18 patients. The ward had beds for patients with progressive and non-progressive neurological conditions who need more rehabilitation following discharge from an acute hospital. This may be following a stroke.

Rehabilitation is also provided for patients who are medically stable but need support to improve their independence. The service provided therapy, education and support enabling patients and their carers to achieve the best possible quality of life.

Harty ward worked on improving mobility, strength, independence in personal and domestic care tasks, cognitive ability, communication and language.

At the time of this inspection the service did not have a registered manager but they had submitted an application.

We had not inspected this location before.

What people who use the service say

Community health services for adults:

Patients told us the teams were very good and responsive. Patients told us they were very happy with the services they were receiving, and that staff were professional. Patients told us that staff took time to explain things to them and they never felt rushed. One patient told us that staff were very interested in their overall wellbeing. Another patient reported that staff provided the equipment they needed very promptly after assessment. Patients and carers told us that staff treated them with dignity and respect and addressed them appropriately.

Community inpatient service:

People who used the service were unanimously positive about the care they received and the staff. They told us that they felt safe, they felt they were being helping to get better, that they were always treated with dignity and respect and that they felt involved in their care. They told us that staff were very responsive, and that they were friendly and took the time to spend with them. They told us that the cleanliness level of the ward was always very high. Some felt frustrated at the delays in receiving packages of care which led to delays in their discharge.

Updated 19 October 2022

We rated this location as good because:

• Staff assessed and managed patient risks well. The provider had a robust safeguarding process and we saw examples of collaborative working with other agencies such as the police and social services to safeguard people from harm. Staff managed safety incidents well and learned lessons from them.
• The service controlled infection risk well. There were hand hygiene stations across the hospital to enable all staff and visitors entering the ward to utilise this and reduce the risk of spreading COVID-19.
• Staff provided good care and treatment. Staff in the community wards ensured that patients had enough to eat and drink. The community adults team assessed patients to ensure their dietary and hydration needs were being met.
• Staff across the services ensured patients had pain relief when they needed it. Managers monitored the effectiveness of their services 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.
• 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. Patients were very positive about the care and treatment they received and praised staff highly.
• The provider planned care to meet the needs of local people and took account of patients’ individual needs. It was easy for people to give feedback and the patients we spoke with told us they felt confident to raise concerns about the care received.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values and felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.

However;

• Staff did not always keep up to date with their mandatory training. Managers told us that they were reminding staff to complete their mandatory training, and some of the face to face training had been rescheduled due to lack of trainers.
• Managers and team leaders did not ensure that clinical supervision was always documented in line with policy. Some staff from the community inpatient service reported that they received one-to-one meetings with their managers on an ad-hoc basis.
• The ward environment on Harty ward did not provide enough space for the safe storage of large equipment, such as hoists, which were stored on a corridor within the ward and created both a trip and evacuation hazard for any patients located in the side room off this corridor.
• Staff did not ensure that patient records on Harty ward were stored securely. Patient notes were stored as paper files in trolleys on the ward. Staff told us that the trolleys were not locked due to a lack of keys. This meant that patient information were not secure.
• Harty ward was not entirely dementia friendly so patients could not always orientate themselves.
• The day room designed to provide a comfortable space for patients away from their bedside, was uninviting, and lacked any comfort or appeal.
• Staff did not ensure that patients’ identifiable information were stored securely on Harty ward. Patient notes were stores as paper files in trolleys on the wards which were unlocked.
• Staff did not ensure that the maximum daily dosage for some medicines such as paracetamol was recorded in patients’ medicines administration chart on Harty ward.
• The continence team did not have a bladder scanner. Although staff informed us that there was a purchase order for a bladder scanner, the teams have been without a bladder scanner for over two months.
• Some services such as the podiatry service and speech and language therapy had a high waiting list, which meant that people might not always be able to access the services when they needed them.
• There was not always enough nursing and support staff on Harty ward to cover shifts. Staff, patients and their relatives told us that staffing was sometimes stretched.

Updated 19 October 2022

We rated the service as good because:

• The service controlled infection risk well. The environments where staff cared for patients were clean and well maintained.
• Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment. Staff ensured that care plans were detailed and supported patient treatment and recovery. They ensured patients who were at the end of their lives received timely pain relief.
• 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 to understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people and took account of patients’ individual needs.
• 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.

However;

• Staff did not always ensure they kept up to date with their mandatory training. Some teams such as the community nursing teams, and speech and language therapy teams were not keeping up to date with their basic life support and anaphylaxis training.
• The continence team did not have a bladder scanner. Although staff informed us that there was a purchase order for a bladder scanner, the teams have been without a bladder scanner for over two months.
• Some services such as the podiatry service and speech and language therapy had a high waiting list, which meant that people might not always be able to access the services when they needed them.
• Patients reported that staff did not routinely collect feedback and the provider was not actively engaging with patients and carers to plan and deliver the services.
• Team leaders did not always record clinical supervisions with staff. Although all staff we spoke to said they met regularly with their clinical supervisors and training and development educators, and these met their needs.

Updated 19 October 2022

We rated it as good because:

• The community inpatient ward had enough staff to care for patients and keep them safe. Staff had training in most key skills and understood how to protect patients from abuse.
• The service controlled infection risk well. Staff followed national guidance for the use of personal protective equipment (PPE) and the ward had a hand hygiene station at the entrance to enable all staff and visitors entering the ward to utilise this and reduce the risk of spreading COVID-19.
• Staff assessed risks to patients, acted on them and kept good care records. 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.
• 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 patients and relatives that we spoke with were happy with the care received and some described it as “excellent” and “brilliant”.
• The service planned care to meet the needs of local people and took account of patients’ individual needs. It was easy for people to give feedback and the patients we spoke with told us they felt confident to raise concerns about the care received. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values and 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.

However:

• Not all staff were fully compliant with all mandatory training. The service told us that access to IT systems was a contributing factor to this.
• The ward environment did not provide enough space for the safe storage of large equipment, such as hoists, which were stored on a corridor within the ward and created both a trip and evacuation hazard for any patients located in the side room off this corridor.
• The day room designed to provide a comfortable space for patients away from their bedside, was uninviting, and lacked any comfort or appeal.
• Patients notes were stored as paper files in trolleys on the ward. Although, these trolleys were not locked due to a lack of keys. This meant that patient information was not secure.
• The ward environment was not entirely dementia friendly so patients could not always orientate themselves.
• Staff told us they received one-to-one meetings with their managers on an ad-hoc basis, and clinical supervision was being carried out in groups, although managers did not routinely record when staff received clinical supervision.
• Staff did not ensure that the maximum daily dosage for some medicines such as paracetamol was recorded in patients’ medicines administration chart
• The service did not always have enough nursing and support staff to cover shifts.