- NHS hospital
Chesterfield Royal Hospital
Report from 26 July 2024 assessment
Contents
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
Safe
Staff we spoke with appeared committed to understand what safe meant to patients, families and partners. Patient safety incidents were reported, staff we spoke with felt that learning was not shared effectively. However, the trust provided evidence of shared learning .For example; disseminated through meetings and news letters. Staff understood how to protect children, young people and their families 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.
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.
Learning culture
Patient safety incidents were reported, however, staff we spoke with felt that learning was not shared effectively. Staff reported this led to a reactive culture and staff had concerns that incidents could be repeated. However, the trust provided evidence of actions and learning from patient safety incidents. We were also provided with meeting minutes and bulletins that identified opportunities for learning. Junior staff identified a number of colleagues leaving the trust as a direct result of a particular incident. We reviewed exit interview information provided by the trust which identified staff leaving for career development.
Information provided evidenced concerns about safety were listened to, safety events were investigated and reported thoroughly, and lessons were learned to continually identify and embed good practices.
Safe systems, pathways and transitions
We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safeguarding
Staff we spoke with appeared committed to understand what safe meant to patients, families, and partners. Patient safety incidents were reported and the trust provided evidence of actions and learning from patient safety incidents. We reviewed meeting minutes and bulletins that identified opportunities for learning. Despite this, staff we spoke with felt that learning was not shared effectively. Due to this staff told us this led to a reactive culture and staff had concerns that incidents could be repeated. Staff we spoke with felt that staffing levels were unsafe. The paediatric assessment unit was unable to offer a full service due to a decrease in staff availability. Staff we spoke with felt this put pressure on the ward area to accept patients that would normally be seen by assessment staff. However, the trust provided evidence of a robust policy and plan that stated the requirements, roles, responsibilities, communication, processes and action to be taken to manage paediatric inpatient admissions and flow, which included all of the children’s services.
Staff understood how to protect children, young people and their families 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. Evidence was provided of actions and learning from patient safety and safeguarding incidents.
Involving people to manage risks
We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe environments
We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe and effective staffing
Staff we spoke with felt that staffing levels were unsafe. However, the trust provided evidence of a reduction in opening hours and days for the paediatric assessment unit (PAU) in order to meet recommended safe staffing levels. Staff were concerned that these changes were temporary and would be removed despite poor staff recruitment and retention. The trust provided evidence that the policy stated the requirements, roles, responsibilities, communication, processes and action to be taken to manage paediatric inpatient admissions and flow within the Trust, including all of the children’s divisions. which included all children’s services within the family care. Registered general nurses with specific paediatric competency were also employed to support the staffing levels within the family care division.
The PAU was open during our visit. Opening times were reduced due to staffing levels in order to ensure patient safety. Due to the distance between the children's emergency area and PAU staff support was usually sought from Nightingale children's ward next door. Depending on patient numbers and acuity on the ward staff told us that this was not always possible. However, to improve staffing numbers and cross cover of the PAU areas the bed base of the ward had been reduced in order to improve patient safety.
Infection prevention and control
We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.
Medicines optimisation
We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.