The Care Quality Commission

Archived: Queen Elizabeth Hospital, Woolwich

Ranken House, Stadium Road, Woolwich, London, SE18 4QH (020) 8302 2678

Provided and run by:
South London Healthcare NHS Trust

Important: This service is now managed by a different provider - see new profile

All Inspections

16 May 2013

During an inspection looking at part of the service

We did not speak to people who used the service as we visited the hospital to follow up on concerns raised at our inspection on 04 March 2013 in relation to the storage of medicines.

At our inspection on 16 May 2013 we found that on 8 out of 13 wards, medicines storage areas were locked when not in use, and medicines were securely stored. On three intensive treatment wards which did not have separate clinical rooms, medicines were stored in open ward areas however these were all stored within locked cupboards and the safety of storing medicines in this way this had been adequately risk assessed. On two wards, we saw that medicines were not securely stored. We discussed this with staff from the pharmacy department, and they confirmed to us in writing on the day following our inspection that they had taken appropriate action on these two wards to secure medicines by fitting a new lock and replacing the medicines trolley. Therefore all medicines were now securely stored.

We found that medicines refrigerator temperature records were now being maintained on all wards, and these showed that medicines requiring refrigeration were being stored at the correct temperatures and were therefore fit for use.

4 March 2013

During an inspection looking at part of the service

We did not speak to people who used the service at our inspection on 04 March 2013 as we visited the hospital to follow up concerns raised at our inspection on 25 October 2012 in relation to the storage of medicines. However, we saw that people had lockable bedside medication cupboards to securely store their personal and prescribed medicines, and medication trolleys used by nursing staff were on most occasions adequately locked and secured. We found people had been adequately supported to take their medicines during our visits to the wards.

At our inspection on 04 March 2013 we found although some medicines storage areas were locked, not all medicines were securely stored or were adequately risk assessed, and we found that fridge temperature records were being inadequately maintained to ensure refrigerated medicines were fit for use.

25 October 2012

During a routine inspection

Our inspection on 25 October 2012 followed up on outstanding improvement actions identified at our inspection on 19 August 2011 in relation to tissue viability care, equipment, medication and record keeping. At our inspection on 25 October 2012 we also checked to see how orthopaedic care was being delivered to patients and we looked at how people's nutritional needs were being met.

Some people who used the service, including those on the orthopaedic ward told us they sometimes had to wait for call bells to be answered by staff. Patients in some other areas of the hospital felt their calls were answered promptly.

Staff and patients on one orthopaedic ward told us on occasions doctors did not see patients for a number of days and there was no daily ward round for orthopaedic patients. People told us they felt the general level of nursing care provided to them was 'good' and records confirmed people's nursing needs had been met.

People told us generally the food was of reasonable quality and they were offered choices. People told us food was provided in accordance with their nutritional needs. Medicines were prescribed and given to people appropriately; however, medicines were not always stored safely. Staff told us the availability of equipment was good and equipment was adequately maintained. People's records we viewed were not always chronologically sorted and therefore were difficult to follow.

During a check to make sure that the improvements required had been made

Following our inspection on 19 August 2011 we asked the trust on 26 September 2012 to provide information to demonstrate it had made the required improvements in relation to consent to care and treatment at Queen Elizabeth Hospital. The trust submitted the requested information on 01 October 2012. This information demonstrated that the trust had made the requested improvements. The trust had carried out a health record audit between June and August 2012 which showed that the majority of the medical and nursing notes it sampled were legible and met NHS Litigation Authority requirements.

The trust demonstrated that it had implemented some recommendations from its consent audit in 2011 such as making improvements to their consent policy and planning a training programme to update staff on the revised policy. The trust told us it had also made improvements in relation to the numbers of staff completing training in the Mental Capacity Act 2005, with 76% of staff by August 2012 completing this training.

28 August and 3 September 2012

During an inspection looking at part of the service

We haven't been able to speak to people using the service because we undertook this review by analysing data and information submitted by the trust in order to demonstrate the required improvements had been made. We gathered evidence of people's experiences by reviewing the trust's survey's conducted in 2011 for maternity, inpatients and outpatients services. In addition we visited the hospital on 03 September 2012 to speak with staff throughout the hospital about their experiences and made ourselves available to staff to contact us by phone after the visit.

Findings from the trusts survey's carried out in 2011 showed that overall people who used inpatients, outpatients and maternity services were satisfied with the care provided to them. A high proportion of inpatients surveyed in the summer of 2011 felt that there were enough nurses on duty to care for them. A slightly lower proportion of inpatients felt they got help quickly when they needed it; however, the score was about the same as the national average.

The trusts outpatient's survey carried out in the summer of 2011 showed that a high proportion of people were satisfied that they did not have to wait long for an appointment, and in general people were satisfied with the outpatient's service.

A maternity survey carried out in September 2011 showed women were appropriately supported by the midwifery team through antenatal, labour and birth and postnatal care. All women surveyed were visited by midwives after the birth of their baby. Compared to the national average, about the same proportion of women felt midwives provided them with active support.

During an inspection looking at part of the service

We haven't been able to speak to people using the service because we undertook this review by analysing data and information submitted by the trust in order to demonstrate the required improvements following our inspection of the hospital's maternity and midwifery services on 18 April 2011 had been made.

The trust's local maternity patient survey carried out in September 2011 found women were satisfied with care they received during labour and birth, and were satisfied with the suturing time following an episiotomy. Women fed back that they were offered a home birth.

Compared to the previous maternity patient survey completed in 2010, there were slightly less positive responses about the length of hospital stay and midwives and carers providing active support. The levels of patients rating of their care during their labour and birth remained the same.

21 March 2012

During a themed inspection looking at Termination of Pregnancy Services

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.

19 August 2011

During an inspection looking at part of the service

We spoke to patients on several wards and in outpatients departments, including the accident and emergency (A&E) department.

People felt they had received good care and treatment; staff explained their treatment to them, treated them with respect and provided good care. People felt that they were seen and treated promptly, and that their care was personalised. The alternatives to and risks of having operations had been discussed with them and hospital equipment was made available to them when required.

Staff were described as 'excellent', friendly, helpful, caring and polite and people told us that they felt safe and secure, and knew how to raise any concerns and who with.

People had been referred for appropriate follow up tests and appointments, with both external and internal departments and other professionals, and most had not experienced any long delays in being seen.

One person told us that his operations had been delayed and cancelled and he was not sure why; some inpatients had experienced delays in staff answering their call bells, particularly at night; there had been delays at discharge due people waiting for their medications to be dispensed; and outpatients told us that hospital transport picked then up very early for their appointments and that they generally had long waits for transport home.

19 April 2011

During an inspection in response to concerns

As part of this review we visited the Labour ward, post and antenatal wards, antenatal clinic and Fetal Assessment Unit.

Women told us that they felt well looked-after throughout their pregnancies and had been treated as individuals, with consideration and respect. They told us staff were available to explain, reassure and assist when needed. All the people we spoke to told us that they felt safe and well-looked after.

Women felt they had been given sufficient choice throughout their pregnancy and labour and felt involved and consulted about their care. They told us they had been given a choice of appropriate pain relief, as and when they required it and had been supported to choose the position most comfortable for them and move around freely during labour. Most said they had been offered home birth as an option. Women had been given the opportunity to hold their babies soon after birth.

Women who had experienced complicated pregnancies were happy with the way in which they had been referred for medical assessments, especially praising the Fetal Assessment Unit (FAU); mothers whose babies were being cared for in the Special Care Baby Unit were confident that they and their babies were getting good care. The visitors we spoke to were also happy with services provided, with visiting arrangements and with the way people were treated with courtesy and consideration by hospital staff.

Some women told us about a lack of continuity of care during their antenatal period, and that they had not seen the same midwife twice. Some women had experienced delays in suturing after giving birth.

23, 25 September 2010

During a routine inspection

People who use services at Queen Elizabeth Hospital told us they were happy with the care they received. Most of them praised nursing staff who they said were caring and kind. However, they also said they didn't think there were always enough staff on duty. Staff told us that they liked working at the hospital although some said they are worried about changes to the trust overall and how this will affect them.