13 June to 11 July 2018
During a routine inspection
Our rating of the trust stayed the same. We rated it as good because:
We rated effective, caring responsive and well-led as good. We rated safe as requires improvement overall.
In outpatients at Ashford Hospital we rated safe and well-led as requires improvement and caring and responsive as good. We did not rate effective. We rated the service as requires improvement overall
In urgent and emergency care we rated safe, responsive and well-led as requires improvement and caring and effective as good. We rated the service as requires improvement overall.
In critical care we rated safety, responsive, effective as good and caring and well-led as outstanding. We rated the service as outstanding overall.
In medicine at St Peters we rated safe as requires improvement and effective, caring, responsive and well-led as good. We rated the service as good overall.
In children and young people’s services we rated safe, effective, caring, responsive and well-led as good, and the service as good overall.
We did not inspect all core services. The previous ratings for those services we did not inspect were taken into account when working out the overall trust ratings for this inspection.
We rated well-led for the trust overall as good.
The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately and could discuss the processes involved.
The service used safety monitoring results well and participated in the national safety thermometer scheme. Staff collected safety information and shared it with staff, patients and visitors. The trust used information to improve the service.
The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection. Standards of hygiene and infection rates were monitored to identify any risks and infection rates were low.
Staff kept appropriate records of patients’ care and treatment. Multi-disciplinary, electronic records were clear, up-to-date and available to all staff providing care.
Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Specialist teams support ward staff and patients in vulnerable circumstances.
The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment. Recruitment, especially of nursing staff was a major challenge to the trust. However, there were systems, including the use of a flexible workforce that ensured there was a match between staff on duty and patients’ needs.
The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance through programmes of audit.
The trust made sure staff were competent for their roles. There was a programme of mandatory training and staff had opportunities to develop their skills and gain experience and qualifications to help them do their jobs effectively.
Staff always had access to up-to-date, accurate and comprehensive information on patients’ care and treatment. Electronic records were used effectively and there were electronic systems to ensure patients’ conditions were monitored