West Berkshire Community Hospital

Updated 7 January 2020

The West Berkshire Community Hospital is part of the Royal Berkshire NHS Foundation Trust

The services provided at this hospital include a Minor injuries unit, outpatient clinics, x-ray, CT, MRI, a haemodialysis unit, and a day surgery unit including endoscopy.

Updated 7 January 2020

We rated it as good because:

The West Berkshire Community Hospital provides services to people living in Thatcham, West Berkshire and the surrounding areas. People living in Thatcham have access to blood tests, physiotherapy and occupational therapy on the site. Since the last CQC inspection in September 2017, a satellite haemodialysis unit has opened on-site.

During this inspection we inspected the haemodialysis unit and the Endoscopy service.

Updated 7 January 2020

This was the first inspection of the Enborne dialysis unit and the Endoscopy service at West Berkshire Community Hospital.

The Enborne dialysis unit is a satellite unit which is part of the Royal Berkshire Hospital NHS Foundation Trust, provides care and treatment for patients with chronic kidney disease needing haemodialysis. The unit provides haemodialysis,  where a dialysis machine and a special filter called an artificial kidney are used for removing harmful substances and waste products from the blood.

The Enborne dialysis unit also holds clinics for patients requiring haemodialysis and outpatient clinics for patients requiring peritoneal dialysis. Peritoneal dialysis is a process which involves pumping dialysis fluid into the space inside the abdomen to draw out waste products from the blood passing through vessels lining the inside of the abdomen.

This was the first inspection of the Enborne dialysis unit and the Endoscopy service at West Berkshire Community Hospital. We undertook an unannounced inspection (people did not know we were coming) on 4 July 2019.

Enborne dialysis unit operates Monday, Wednesday and Friday between the hours of 7 am to 7.00 pm. On Tuesday, Thursday and Saturday from 7 am to 3.00 pm.

The Enborne dialysis and the Endoscopy services do not have any inpatient beds and all patients are treated as day cases and discharged home.

The Enborne dialysis unit provides care to patients living in Berkshire and the surrounding areas. The service is delivered from a purpose- built facility situated in Thatcham. It consists of eight treatment couches and two side rooms; which staff could use for isolation purposes.

The Enborne dialysis unit also offers holiday dialysis for patients who are holidaying in the area and this is pre- planned in order to meet demands.

The Endoscopy service has 12 couches which are in designated male and female areas. There are also two side rooms which ca be used for isolation purposes if needed. There is a comfortable waiting area for patients. Consultants at Royal Berkshire Hospital assess and refer all patients for care and treatment to the Endoscopy unit.

The Endoscopy service does not hold the joint advisory group (JAG) accreditation on gastrointestinal endoscopy. The JAG accreditation scheme is a patient centred and workforce focused scheme based on the principle of independent assessment against recognised standards.

During our inspection, we spoke with four patients. We reviewed three patients’ records and spoke with six staff members.

We did not speak with any patients in the Endoscopy unit as there was no one receiving care at the time of our inspection.

We also reviewed other data and information relating to the trust including audits and performance data.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led.

We rated it as good because:

• Staff followed processes for reporting incidents which were investigated, and action plans were developed to address any shortfalls. Lessons learnt were shared locally and trust wide.
• The service used systems and processes to safely prescribe, administer, record and store medicines. Patients medicines were reviewed, and any changes were discussed with the patients’ consultants.
• Staff looked after equipment well and followed infection control procedures to minimise the risks of cross infection.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff followed the trust’s safeguarding policies and procedures and were able to recognise and reported abuse.
• The service provided care and treatment based on national guidance and evidence-based practice. These included the National Institute for Health and Care Excellence (NICE) and British Society of Gastroenterology. Managers checked to make sure staff followed guidance
• There was effective multi-disciplinary working where staff of different roles such as dieticians and specialist nurses worked well together for the benefits of patients. They supported each other to provide good care.
• Staff gained consent from patients for their care and treatment in line with legislation and guidance.
• Staff gave patients enough food and drink to meet their needs and improve their health. They provided patients with advice on healthy diets and fluids management which was essential part of dialysis treatment.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• Patients were complimentary about their care and treatment that they were receiving.
• The service took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services in a timely manner.
• The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. The service followed the trust procedures and patients were given the opportunity to have face to face meetings as part of the complaint’s investigation.
• Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and developed action plans to reduce their impact

However;

• The trust told us there was a policy for the management of patient's own controlled drugs.  However; the senior staff we spoke with did not know about the policy and procedure for managing patient’s own controlled medicines. The staff member could not locate the medicine policy.
• The team leaders did not always attend meetings at the trust and opportunities to build relationship and learning were missed. The trust told us that minutes of meetings were shared with the staff.
• The Endoscopy service did not meet the JAG accreditation standards it was assessed against prior to our inspection. The assessment team noted some areas that did not meet the JAG standards. The trust told us the  award of accreditation was therefore deferred for 6 months to complete the actions identified. The trust had developed an action plan in order to work on these areas as identified during the JAG assessment.