Sittingbourne Memorial Hospital

We rated this location as good because:

• Staff understood how to protect patients from abuse, and managed safety well. All patients that we spoke with told us that they felt safe.
• Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Managers and staff gave us examples of recent lessons learnt from incidents and changes that had been made to prevent this from happening in the future.
• Staff across the services controlled infection risk well.
• The teams used systems and processes to safely prescribe and store medicines.
• Staff provided good care and treatment and gave them pain relief when they needed it. Managers monitored the effectiveness of the service. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers. The patients we spoke with were happy with their care; one patient described the service as “excellent”.
• The provider planned care to meet the needs of local people and took account of patients’ individual needs. Patients we spoke to told us they felt confident to raise concerns about the care received.
• Leaders ran services well and staff felt respected and supported. They were focused on the needs of patients receiving care and clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However;

• Staff did not always ensure they kept up to date with their mandatory training. Some teams such as the community nursing teams, and speech and language therapy teams were not keeping up to date with their basic life support and anaphylaxis training.
• Team leaders across the core services did not always record clinical supervisions with staff. Although all staff we spoke to said they met regularly with their clinical supervisors and training and development educators, and these met their needs. Staff from the inpatient services told us they received one-to-one meetings with their managers on an ad-hoc basis, and clinical supervision was being carried out. We saw that one staff member had not received clinical supervision for over a year.
• Not all staff were fully compliant with the essential safety modules of fire safety and evacuation which fell below the service’s target and not all staff had attended fire evacuation drills in line with the provider’s policy in the inpatient services. The service did provide an action plan which showed that the remaining staff had been booked onto a training session.
• There were staff vacancies across all core services. Some community health services teams were reporting they were quite stretched. On the inpatient units, we saw that shifts were covered by bank or agency staff who did not always know the patients well.
• The ward environment in the Kestrel ward was not dementia friendly so patients could not always orientate themselves. The wards did not have dementia assistive aids in place.
• Some services such as the podiatry service and speech and language therapy had a high waiting list, which meant that people might not always be able to access the services when they needed them.
• On the Community inpatients wards, we saw that staff did not ensure that patients’ maximum dosage for medicines were stated on their medication chart. For example, we saw that there had been no indication for eight different medications on one patient record. For another patient with a low weight, no maximum dosage was shown for paracetamol.
• The continence team did not have a bladder scanner. Although staff informed us that there was a purchase order for a bladder scanner, the teams have been without a bladder scanner for over two months.
• Some services such as the podiatry service and speech and language therapy had a high waiting list, which meant that people might not always be able to access the services when they needed them.
• Patients we spoke who were receiving care from the community health services for audits teams reported that staff did not routinely collect feedback and the provider was not actively engaging with patients and carers to plan and deliver services.
• The phlebotomy clinic was quite small with two patient chairs next to each other. This impacted on dignity and privacy. Although staff told us they could draw the curtains, people in the room could still overhear the conversations of others.