Weston General Hospital rating moves up from 'inadequate' to 'requires improvement'
The Care Quality Commission assesses services in five areas. The current ratings for the hospital (and the rating change since each service was last inspected) are:
Is the service safe? Requires improvement (previously inadequate)
Is the service effective? Good (previously requires improvement)
Is the service caring? Good (no change)
Is the service responsive? Requires improvement (no change)
Is the service well-led? Good (previously inadequate)
Is the service safe?
Inspectors found that staff mostly received and kept up-to-date with their mandatory training. Staff understood safeguarding procedures, and how to protect patients from abuse.
Hospital premises and equipment was kept visibly clean, and staff ensured good levels of cleanliness and hygiene. However, the surgical day case unit was not always operating within the trust's operating standard:
- Staff said patients who were confused were sometimes admitted to the ward.
- There were insufficient oxygen and suction points.
- Patients did not have access to individual lighting by their bed.
- Patient beds were close together, which limited privacy and there was no space for chairs for patients or visitors to use.
- There were patients remaining on the unit for a week or more and there were no shower facilities on the unit.
Inspectors highlighted that staff also did not always identify and quickly act upon patients at risk of deterioration. Venous thromboembolism (VTE) assessments, which should be completed for all patients on admission to hospital, had not been consistently completed and reviewed. This created a risk for patients. Overall, the hospital had enough nursing and support staff to keep patients safe, and had made significant improvements around recruitment, but there were still some recruitment gaps.
From August 2021 to August 2022, Weston General Hospital reported 12 serious incidents within medicine. These included instances including pressure injuries, diagnostic delays , treatment delays and medication incidents. We saw the service carried out root cause analyses and patient safety incident investigations into these incidents. Actions were identified and shared.
Is the service effective?
Inspectors identified evidence-based care and treatment. Patients had enough to eat and drink, and were given pain relief when needed and in a timely way. However, key services such as mental health services and diagnostic tests were not always available 24 hours a day, seven days a week.
Is the service caring?
Staff treated patients with compassion and kindness, and provided emotional support to patients, families, and carers. People were also supported to understand and make decisions about their care and treatment.
What did patients say?
"Every member of staff has been lovely. I don’t feel like an inconvenience. I have received high levels of care, attention and professionalism. I cannot praise them enough."
"Staff are so kind, excellent stay. Not in any pain, they answer the call bell and the food has been good."
"Very good care, brilliant staff are kind, patient and very good. It’s easy to join in the exercises. Food is very good. Able to get help to use the toilet and call bell is answered."
However, some staff told us staffing pressures meant they did not always have time to do anything more than provide basic patient care. Inspectors said those staff were clearly distressed when they found themselves in a position when they couldn’t spend more time with patients individually.
Is this services responsive?
Inspectors found the hospital did not always plan and provide care in a way that met the needs of local people and the communities it served.
The management team were under considerable pressure to find beds for patient admissions, but the system to manage flow throughout the hospital was not completely effective. The increasing demand in the hospital outweighed the available capacity. Throughout the inspection, the hospital had 100% bed occupancy with no beds available for admissions. Inspectors also found that some patients stayed longer than needed, due in part to the difficulties securing onward care.
Is the service well-led?
Since our last inspection in 2021, a new senior management team had been introduced to Weston General Hospital. The management team fully understood and managed the priorities and issues the service faced.
Most staff felt respected, supported, and values, but cultural issues remained on some wards. These issues centred on poor experiences being had by staff from minority ethnic backgrounds.
There were ongoing concerns around racist behaviours and discrimination felt by staff who were from ethnic minority backgrounds. Additionally, to this we heard of problems faced by staff who had been recruited from overseas. Due to the requirements relating to these staff, the timeframe for them being able to fully take up posts was extended. This caused friction in some areas and risked them being segregated as a group from the rest of the workforce. We raised these concerns with the leadership of the trust immediately and were provided reassurance this issue would be tackled as a priority.
Some staff said they often worked over their paid hours. Ward managers and matrons in particular worked excessive hours to complete their tasks. They often worked on wards to keep patients safe by ensuring there were enough staff to care for them.
Click here to read the full CQC inspection report for Weston General Hospital.
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