Archived: Samuel Johnson Community Hospital

Updated 22 October 2015

The Samuel Johnson Community Hospital is part of Burton Hospitals NHS Foundation Trust. The hospital provides a minor injuries unit, medical care and rehabilitation on two wards, maternity services and outpatients. The hospital is based in Lichfield, 13 miles from the main trust site in Burton Upon Trent.

The trust serves a population of more than 360,000 people in Burton upon Trent and surrounding areas, including South Staffordshire, South Derbyshire and North West Leicestershire.

Updated 22 October 2015

Samuel Johnson Community Hospital is part of Burton Hospitals NHS Foundation Trust. The hospital provides a number of services to the local population of Lichfield, working closely with neighbouring hospitals and NHS trusts.

We inspected this hospital in July 2015 as part of the comprehensive inspection programme.

Overall, we have rated this hospital as good. We saw that services were caring and compassionate. We also saw that people have good outcomes because they receive effective care and treatment that met their needs. Systems and processes were in place to ensure patients were kept safe and were able to respond to local need. The minor injuries unit required improvement in order for it be considered responsive to people’s needs and well led.

Our key findings were as follows:

• Staff were caring and compassionate towards patients and their relatives. Patients’ dignity and privacy was ensured and we saw many examples of good care right across the trust for staff at all levels.
• There was a strong open culture and staff were encouraged and supported to report incidents. There were clears systems in place to ensure lessons were learnt and services developed as a result
• The hospital delivered an effective and responsive service that met the needs of the local community.
• Staff at Samuel Johnson hospital described how the computer systems at the hospital were not all compatible with those at the trusts other sites. Provision had been made so that information was available, but this was read only.

We saw several areas of good practice:

• Dementia care was embedded within the wards. Nurses, nursing assistants and volunteers were trained as dementia champions; they encouraged others to make a positive difference to people living with dementia.
• Multi-disciplinary working was embedded on the wards. The ward based physiotherapists and occupational therapists (OT) supported the nurses in the patient rehabilitation pathway and promoted safe patient independence during their rehabilitation programme.
• We heard of the strong emphasis on a drive for quality, good communication and ongoing enhancement of staff’s skills.
• We saw good examples of multi-disciplinary team (MDT) working across the maternity service. Staff worked collaboratively as part of the multidisciplinary team to serve the interests of women in birthing at the unit and those cared for in the community setting.

However, there were also areas where the trust needs to make improvements:

Importantly the trust must:

• The trust must review arrangements for responding to patients with mental health needs in the minor injuries unit.
• The trust must review arrangements for access to x-ray imaging after 5pm weekdays and on Saturday afternoons and Sundays or MIU patients.
• The trust must support the MIU to audit its performance in order to assess the effectiveness of their own practice and to identify and manage risks.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 22 July 2014

We visited two elderly care wards at the Samuel Johnson Community Hospital. The Anna Seward ward and Erasmus Darwin ward.

Local risks were managed effectively, but we highlighted concerns with hand hygiene practice and nurse staffing levels at night time. There was seven day access to therapies and allied healthcare professionals who provided appropriate input as required. Patients told us that they felt informed and included in decisions about their care and treatment.

The trust does not always respond appropriately to the needs of all patients with dementia. The lead dementia nursing team consists of two staff, who are not resourced to support all patients with a diagnosis of dementia at the community hospital.

We observed good local leadership on the wards with senior nurses demonstrating a commitment to patient safety and the management of risk. One senior nurse on Erasmus Darwin ward had been nominated for a national award upon completion of a project which reduced the risk of falls to the ward’s patients.

Updated 22 October 2015

There was clear systems in place for reporting safety incident, audits concerning safe practice and compliance with best practice in relation to care and treatment.

People received care and treatment that was planned in line with current evidence-based guidance, standards and best practice.

Women told us they had a named midwife. The ratio of clinical midwives to births was one midwife to 29 women. We saw documentary evidence that 99% of women received one to one care in labour. Women told us that they felt well informed and were able to ask staff if they were not sure about something.

There was a clear statement of vision and strategy, driven by quality and safety. However, most staff we spoke with did not demonstrate awareness or understanding of the vision and strategy.

The governance arrangements facilitated discussion and review of quality and safety matters, with dissemination of learning. There was oversight of quality and safety at the trust board meetings.

Updated 22 October 2015

Updated 22 October 2015

We found services were not as responsive as they could be. The MIU was in a district general hospital and there was no ED within the hospital. The ambulance service took patients with major injuries or illness to the ED at Queens Hospital Burton or to Good Hope ED Sutton Coldfield. The hospital did not have good support arrangements for people with mental health issues, especially at night. There was no access to x-ray imaging after 5pm weekdays or on Saturday afternoons or Sundays. They did not have joined up working with some other specialists such as the mental health crisis team.

We found leadership required some improvement. The trust did have monthly meetings about the performance of MIU. Managers regularly collected monitoring information but they did not use it and it could help them to understand and manage risks more effectively.

Staff reported and learned from any incidents or mistakes. There were good systems in place to keep patients safe. Experienced emergency nurse practitioners led the MIU.

They provided treatment and care through nationally agreed methods and offered pain relief as needed. All staff treated patients and their relatives or friends with respect and warmth. They upheld the patient’s privacy and dignity.

Updated 22 October 2015

Patients, visitors and staff were kept safe as systems were in place to reduce and monitor risk. Services followed recognised pathways of care and were completed by trained and skilled staff. Patient outcomes were audited and benchmarked against national standards.

Staff were caring and involved patients and their carer’s and family members in decisions about their care. The service was responsive to the local community. Local leadership was good. Managers understood their staff and provided an environment where they could develop.

Formal complaints processes were embedded however we did not see evidence that informal complaints were being recorded in line with the trust complaints policy.