Archived: Sir Robert Peel Community Hospital

Updated 22 October 2015

The Sir Robert Peel Community Hospital is part of Burton Hospitals NHS Foundation Trust. The hospital provides a minor injuries unit, medical care and rehabilitation on one ward, day-case surgery and endoscopy services and outpatient clinics. The hospital is based in Tamworth, 20 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

The Sir Robert Peel Community Hospital is part of Burton Hospitals NHS Foundation Trust. The hospital provides a number of services to the local population of Tamworth, 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 had 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.

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 from staff at all levels.
• The hospital delivered an effective and responsive service that met the needs of the local community.
• The numbers of patients using the day case unit had declined and there were concerns regarding the long term sustainability. A decision to close the unit was postponed until 2016, following consultation with staff and the local community.
• 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

We saw several areas of good practice:

• There was good joined up working in the minor injuries unit with other specialists such as the mental health crisis team and the mental capacity service team within the hospital.
• The five steps to safer surgery (part of the World Health Organisation (WHO) surgical safety checklist) was said by staff to be well embedded and the latest audit report showed high levels of compliance.
• Staff told us senior leaders and the executive team were approachable and visited the hospital on a regular basis.
• The surgical team were working towards Joint Advisory Group (JAG) accreditation for gastrointestinal endoscopy services.

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

Importantly the trust must:

• The trust must review arrangements for access to x-ray imaging after 5pm weekdays and on Saturday afternoons and Sundays for 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 October 2015

We found that medical services at the Sir Robert Peel Community Hospital provided an effective rehabilitation service to the local community and surrounding hospitals. The staff were trained and competent to provide a safe service in a positive friendly environment.

The ward was found to be clean and we saw that the staff followed infection prevention and control policies and procedures. We saw that learning from incidents was embedded and had improved care and practices; especially relating to falls and falls prevention.

A strong multi-disciplinary team worked together to enhance the patients experience and enabled people to safely return home or to a community setting within a reasonable time scale.

Risk assessments and individualised care plans ensured that patients received the optimum experience for their needs. Patients and those close to them told us they had received good care from friendly, professional staff. Staffing levels were supported by bank or agency staff; a rolling programme of recruitment was in place to address vacancies. Staff told us they felt valued and listened to.

Updated 22 October 2015

Updated 22 October 2015

Staff reported and learned from any incidents or mistakes. There were good systems in place to keep patients safe. The MIU was led by experienced emergency nurse practitioners. There was a high rate of staff sickness and maternity leave absence this was covered by other staff working extra shifts.

Treatment and care was provided through nationally agreed ways and pain relief was offered as needed. There was good joined up working with other specialists such as the mental health crisis team and the mental capacity service team within the hospital. There was no access to x-ray imaging after 5pm week days or on Saturday afternoons or on Sundays. Patients had to go to other local hospitals.

Patients were seen on a ‘first come, first served’ system but reception staff could send patients with particularly risky symptoms and all children under a year old straight through to see a nurse. All staff treated patients with respect and warmth. Patients told us they were satisfied with the care they received.

We found leadership required some improvement. The trust did have monthly meetings about how the MIU was performing, but it was not using some of the important monitoring information that was being collected to make sure all the risks were known about and managed safely.

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.

Updated 22 October 2015

Staff were caring, professional and friendly. Patients were involved in their care and treatment and encouraged to ask questions. We reviewed patient care records, these were appropriately completed with sufficient detail. We saw systems were in place to monitor patient risk and maintain a safe service.

Staff were confident in reporting incidents and were aware of the importance of duty of candour, informing the patient when things go wrong. Staff displayed good compliance results with the NHS safety thermometer. Medical and nursing staff felt as though they had safe staffing levels. All staff that we spoke with told us they worked well as a team. We saw there was joint working with the Queen’s Hospital surgical division. All medical staff worked across both sites. We saw the team were working hard to complete all audits in order to gain accreditation for the endoscopy unit.

The unit had experienced a reduction in its utilisation in recent years and the trust were concerned over it’s long term sustainability. A decision to close the unit was postponed until 2016, following consultation with staff and the local community.