Orpington Hospital

Updated 9 September 2022

We carried out a focused responsive inspection visit to two Older Adult Medicine wards at Orpington Hospital on 11 July 2022. This was as a result of receiving concerning information about standards of care.

We spoke with eight patients, one relatives and 17 staff. A range of information was reviewed by us on site and as provided from the trust after our visit. We looked at seven records related to patient treatment and care. We made observations of staff interactions with patients and one another, how the multidisciplinary team worked, and the general environment.

We found:

• Staffing levels did not always enable staff to provide the standards of care they aspired to.
• Not all staff had a full understanding of how to protect patients from abuse. Care and treatment was not always delivered in a responsive manner and did not always reflect the preferences of patients. Patients were not always treated with dignity and respect. Staff did not always feel valued and listened to. As a result, they did not always report matters of concern via the incident reporting system. There were missed opportunities for managers to be informed of these, to investigate and learn from the issues.
• Medicines were not always managed safely.

However:

• Staff had training in key-skills and safety related subjects. Infection risks were well managed, and the environment was suitable for patient’s needs.
• Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from these.
• Staff ensured patients had enough to eat and drink and ensured their pain levels were assessed and managed. They treated patients with kindness and respected their privacy. Staff provided emotional support to patients, their families and carers.
• There was good multidisciplinary working and sharing of information. Key services were available seven days a week.

Updated 9 September 2022

Updated 30 September 2015

The outpatients and diagnostic imaging department was a calm and comfortable environment for patients. Patients we spoke with on the day of our inspection were very pleased with the care that they had received in the department. They told us that their care had been unhurried, caring, and that they felt well informed about their choices and treatment.

Overall, staff provided a caring and compassionate service, and we observed staff treating patients with respect. Patients and their relatives and carers told us that they felt well-informed and involved in decisions about their care and treatment. The service was delivered by trained staff who were provided with induction, mandatory and additional training specifically tailored to their roles.

The leadership, governance and culture within the department promoted the delivery of person-centred care. Staff were supported by their local and divisional managers. Risks were mostly identified and addressed at local level or escalated to divisional, or directorate level if necessary. We noted that the trust promoted and supported a good working culture within the organisation through their regular engagement with staff.

However, we found that most clinics were often run without the patients' medical notes.   In addition, in the imaging department, there was no warning light on the DEXA X-ray room, however there was a warning sign on the door which meets the legal requirement under the Ionising Radiations Regulations (Regulation 18).

Updated 30 September 2015

There were effective systems and processes on the orthopaedic ward and in theatres to provide safe care and treatment for patients. Staff were aware of how and when to report incidents. Patient safety was monitored and incidents were investigated to assist learning and enhance the delivery of safe care.

The surgical unit followed national clinical guidelines and staff used care pathways effectively.

The staffing levels and skills mix was sufficient to meet patients’ needs. Patients were supported with the right equipment. Patient records were completed appropriately. We found that staff had a good understanding of the Five Steps to Safer Surgery and fully completed the theatre checklist.

Staff were caring and compassionate, and patient dignity and privacy was respected.