The Droitwich Spa Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service managed patient safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Staff had the required levels of training for safeguarding children and vulnerable adults. Staff knew what actions they should take to keep people safe from avoidable harm and abuse. There were safe systems and pathways to maintain safe systems of care in which patient safety was managed, monitored and assured. There was continuity of care when people moved between different services. The service had processes to ensure staff assessed the risks to patients, so they were supported to stay safe. The design, maintenance and use of facilities, premises and equipment kept people safe. The service had enough staff with the right skills, training and experience who received effective support, supervision and development. Staff worked together effectively to provide safe care that met people’s individual needs. The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean. The imaging service used systems and processes to safely prescribe, administer, record and store medicines according to evidence-based practice.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said they would share concerns with staff if they needed to and were confident their concerns would be listened to and acted upon.

There was a positive culture of safety based on openness and honesty, in which concerns about safety were listened to. Managers investigated safety events and identified lessons learned which were shared with their team to enable good practice to be embedded.

The imaging service had appropriate systems and processes for staff to report incidents including near misses and for these to be acted upon. Managers had oversight of all reported incidents to identify themes and trends. Following any incidents, feedback was given to staff and patients to help improve the service.

Staff communicated with other health care providers to ensure continuity of care and timely sharing of diagnostic tests. Patients told us they were referred onwards to their GP, consultant or specialist services if their diagnostic imaging results required this.

Staff and leaders monitored the timeliness with which patients received their diagnostic tests. Staff shared results with the referring clinician. Managers also monitored the quality of the tests and identified when improvement was required. This information was shared with staff to ensure continuous improvement within and external to the service.

There were appropriate systems and processes to support people to continue with their treatment after receiving diagnostic tests. There were systems to ensure test results were shared with GPs and other specialists, as necessary. Staff worked as part of a wider team to ensure patients who required further tests or treatment received this.

Patients we spoke with did not raise any concerns, or give any feedback, about safeguarding at the service.

Staff were aware of the processes to follow if they had concerns a patient was at risk of abuse or neglect. Staff told us that if they were concerned about a patient, they would speak to a manager or safeguarding lead for advice.

All staff had completed required safeguarding training. Staff had access to up to date safeguarding policies to support staff to keep people safe and identify and report abuse or neglect. Safeguarding policies were reviewed and were up to date. They reflected relevant legislation and local requirements to keep people safe and identify and report abuse or neglect. The hospital had a safeguarding lead who had received additional safeguarding training and was available to advise and support staff.

Patients we spoke with said staff discussed their health needs with them to ensure risks to their health from any diagnostic procedures were identified and managed.

Staff assessed patients using up to date, evidence based, clinical guidance prior to undertaking any procedures.

Patients did not report any concerns with the safety of the equipment used as part of diagnostic testing. Patient feedback was positive about the overall hospital facilities.

Staff had access to equipment, facilities and an environment which kept them and patients safe. Staff were trained to use specialist equipment.

The facilities and equipment were observed to be safe. We checked a sample of equipment and found all were maintained in line with the manufacturer’s guidance. We observed staff and patients had access to safety equipment to reduce the risk of over exposure to radiation. Staff wore radiation badges in controlled areas to ensure that radiation exposure limits were monitored, and appropriate action undertaken when required. Rooms where ionising radiation exposures occurred were clearly indicated. There were signs and warning lights outside controlled areas where radiation was used to make it clear when it was safe to enter.

There were appropriate processes to ensure the facilities and equipment were safe. The imaging service did a range of audits to determine compliance and safety which met evidence-based practice including guidance published by the Royal College of Radiologists and the iRefer guidelines. iRefer is a tool published by the Royal College of Radiologists to promote evidence-based imaging. The audit results were shared within the service and benchmarked with other locations run by the provider. Diagnostic imaging had 'local rules' identified to maintain radiation safety. Local rules are instructions for the room or place in which radiography is conducted to ensure safety in the specific setting. The radiation protection supervisor (RPS) ensured compliance with (IR(ME)R 2017 regulations and the Ionising Radiations Regulation 2017 in respect of work conducted which was subject to 'local rules'. Staff radiation exposure was monitored by the radiation protection supervisor and records of dose badges were monitored and recorded. Appropriate action would be taken if overexposure was identified.

There were sufficient staff to provide the diagnostic imaging service to all patients in a safe manner. Patients had time to ask staff questions during consultations and procedures. Patients said staff were knowledgeable and helpful.

The service had sufficient staff to provide safe and quality care to patients. At the time of our visit, the service had no vacancies and was fully staffed. All staff received an annual appraisal of their work and the opportunity to discuss any concerns or professional development opportunities. Managers monitored staff compliance with training and ensured staff were competent to undertake their roles.

We observed there were enough staff to deliver the service to the number of patients booked in during our visit. We saw all staff in the department, including administration staff and radiographers, worked well together to provide safe care and procedures. Staff received mandatory training courses in key skills. This included equality, diversity and human rights training, resuscitation, health and safety, and a full range of other standard subjects. Imaging staff also received role specific mandatory training including IR(ME)R and MRI modules, patient safety and inhouse competencies.

The service used a staffing tool for radiography staff and ensured there were 2 radiographers available for contrast injections with set sessions identified. The service had suitable processes to ensure staff were recruited safely and received training in line with their roles. Staff had all received mandatory training courses in key skills including manual handling, health and safety, infection control, conflict resolution, equality, diversity and human rights, fire safety, information governance and data security, preventing radicalisation, resuscitation, safeguarding vulnerable adults and safeguarding children. Imaging staff also received role specific mandatory training including IRMER and MRI modules, patient safety and inhouse competencies. Managers had oversight of staff training records and reminded staff when they needed to complete mandatory training. Managers undertook supervision and appraisals with staff to monitor performance and to encourage continued professional development.

Patients we spoke with did not raise any concerns about the cleanliness of the environment or equipment.

Staff used personal protective equipment (PPE) and other control measures to protect patients, themselves and others from infection.

We observed the environment, facilities and equipment to be visibly clean during our visit. We saw appropriate cleaning products were used safely to minimise the risk of cross contamination. Staff performed effective hand hygiene whilst working with people. We observed staff to wash their hands regularly in between patients.

The service had appropriate systems to ensure the environment and equipment were clean and minimised the risk of cross infection. Cleanliness and infection control practices were audited by the service.

Medicines for treatments such as (contrast) injections were safely managed.

We observed the safe storage and arrangements for medicines to ensure patients’ safety. We checked the temperature of areas (rooms and medicine fridges) where medicines were stored, and this was monitored daily and recorded. We checked all medicines stored and all were within the date before expiry.

There were appropriate processes to ensure the safety of medicines and treatment and this was audited and monitored. Prior to the diagnostic procedure, checks were made on patients’ medicines, medicine allergies, and any previous treatment reactions. The imaging service did monthly medicines audits to check medicine arrangements were safe. Information around new medicines and medicine alerts were shared with the team during medicines management team sessions. Medicines used within the imaging service were administered under patient group directions (PGDs), with each patient having a prescription which was signed off by a radiologist. PGDs provide a legal framework that allows some registered health professionals to supply or administer a specified medicine to a pre-defined group of patients, without them having to see a prescriber.