South Tyneside District Hospital

We rated services as good because:

• We rated safe, effective, caring, responsive and well led as good.
• We rated six services as good and one service as requires improvement.
• The service provided mandatory training in key skills, including safeguarding training, to all staff. Staff had training on how to recognise and report abuse. The service controlled infection risk well. Staff completed and updated risk assessments for each patient and took action to remove or minimise risks. The service had enough staff with the right qualifications, skills, training and experience. Staff kept detailed records of patients’ care and treatment. The service managed patient safety incidents well.
• The service provided care and treatment based on national guidance and best practice. Staff gave patients enough food and drink to meet their needs and improve their health. Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way. Staff monitored the effectiveness of care and treatment. Key services were available seven days a week. Staff supported patients to make informed decisions about their care and treatment.
• 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, families and carers to minimise their distress. They understood patients personal, cultural and religious needs. Staff supported patients, families and carers to understand their condition and make decisions about their care and treatment.
• The service planned and provided care in a way that met the needs of local people and the communities served. The service was inclusive and took account of patients’ individual needs and preferences. People could access the service when they needed it and received the right care promptly. It was easy for people to give feedback and raise concerns about care received.
• Local leaders had the skills and abilities to run the service. They were visible and approachable in the service for patients and staff. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service had an open culture where patients, their families and staff could raise concerns without fear.

However:

• In a number of services appraisals and mandatory compliance rates fell below the trust target. The facilities in the emergency department for conducting assessments of patients with mental health conditions were not compliant with national guidance. We had staffing concerns on the medical care wards. The critical care service was not fully meeting the GPICS standards for medical and allied health professional staffing. We found medical devices which were out of date for servicing and maintenance.
• Staff in surgical services had limited understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. In critical care services we found some printed guidelines which were out of date and there were not enough clinical educators to meet the GPICS standards.
• Surgical services were not meeting the trust targets for theatre utilisation. In some services identified risks had been on the risk register for a number of years and mitigating actions were not sufficient to reduce their impact and we saw limited examples of cohesive working across the trusts two critical care units. Whilst some services had a vision for what they wanted to achieve, the strategies were not yet developed. Some services needed more work to ensure effective governance processes were in place. We did not see or hear of many examples of innovation, improvements or research.