Paulton Memorial Hospital

HCRG Care Services Ltd provide services in the local community. There are two community hospitals serving the population of Bath and North East Somerset, situated at St Martin’s Hospital (29 beds) and Paulton (28 beds). Paulton Memorial Hospital offer “step-up” beds (to prevent admission to an acute hospital bed), a minor injuries unit and an out-patients department. There is a physiotherapy service and an x-ray service is provided from Monday to Friday by another healthcare organisation.

We rated this location as requires improvement because:

• The target for mandatory training in key skills for in-patient staff was not met.
• Ward staff assessed risks to patients, but assessments lacked evidence of escalation where high risks were identified.
• Care plans did not detail inpatients’ preferences on how their needs were to be met. Their care plans were not developed on all areas of need or on their discharges. Action plans did not provide guidance to staff on how assessment needs were to be met or reviewed where assessments had identified further action with monitoring potential deterioration.
• Medicine systems on the ward were not fully safe. There were gaps in the recording of medicines administered. Staff did not always record the reasons for not administering medicines.
• Whiteboards with patient’s details were in full view of patients and visitors to the ward.
• Although steps were taken to recruit and retain staff, high levels of agency staff were used on the ward to maintain basic staffing levels.
• Ward staff did not feel valued by the organisation due to the lack of resources and staff shortages.
• The x-ray department was not open during the evening or at weekends. This was provided by another hospital and not within the service’s authority to change opening hours.

However:

• The minor injuries unit (MIU) had enough staff to care for patients and keep them safe.
• All staff were committed to delivering good standards of care. The clinical lead in the MIU monitored the effectiveness of the service and made sure staff were competent.
• Staff treated patients with compassion and kindness, took account of their individual needs and helped them understand their conditions.
• Senior staff in the MIU planned care to meet the needs of local people and took account of patients’ individual needs. Patients could access the service when they needed it and did not have to wait too long for treatment.
• The leadership, governance and culture in the MIU were used to drive and improve the delivery of high-quality person-centred care.