Halton General Hospital

Updated 24 July 2019

Halton General Hospital and the Cheshire and Merseyside Treatment Centre are located on the same site on the outskirts of Runcorn, Cheshire.

Halton General Hospital is where all elective work is carried out together with two integrated/ intermediate care wards; the Clatterbridge chemotherapy Centre, Macmillan Delamere Centre. The Runcorn Urgent Care Centre is located at this site.

The Cheshire and Merseyside Treatment Centre is also located on the Halton General site which is a centre for orthopaedic surgery and sports medicine.

The following CQC cores services are provided at the Halton site:

• Urgent and emergency care
• Medical care
• Surgery
• Outpatients

There are 44 elective surgical beds and 22 intermediate care beds at Halton General Hospital and 42 trauma and orthopaedic beds at the Cheshire and Merseyside Treatment Centre.

Between February 2018 and January 2018 there were 15,000 inpatient admission and 112,000 outpatient appointments.

Updated 24 July 2019

Our rating of services improved. We rated it them as good because:

• The hospital had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The hospital controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They generally managed medicines well. The hospital managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of services and made sure staff were competent. 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. Key services were available seven days a week.
• 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 hospital planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access services when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the trust’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The services engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However,

• In surgery, we observed one instance of a controlled drug being left unattended in the operating theatres and found some consumables that were past their use by dates. Some patient trolleys also had not had annual maintenance.
• In surgery, some processes around the pre-operative briefing were not thorough, but work was in progress to improve this.
• In surgery, we saw an example of mental capacity assessment not in line with current guidance and trust policy.

Updated 27 November 2017

At our last inspection in January 2015 we rated medical services as good. We have maintained the overall rating following this inspection because:

There were systems in place to ensure risks to patients were minimised. Staff completed risk assessments and records were completed fully and accurately. The environment was visibly clean and staff followed infection prevention and control best practice including strict decontamination procedures in endoscopy.

Nursing staffing and medical cover was generally adequate to meet the needs of patients although there were times when nursing staffing fell below the expected level.

Medicines were stored appropriately and checks were carried out regularly on essential emergency equipment.

However:

There was open access to clinic areas where clinical supplies and medical records were stored. On PIU, trolleys were stored unsupervised in the bay areas with clinical supplies such as needles, cannulas and sterile water for injection.

Basic life support training for the acute care division was below the trust target. Safeguarding rates for medical staff were also below the trust target.

Updated 10 July 2015

Systems were in place for reporting and managing incidents. There was a risk-aware culture in the department and a willingness to learn from mistakes. Patients received care in safe, clean and suitably maintained environments with the appropriate equipment. Staff were aware of their role in safeguarding and could escalate concerns about abuse and neglect appropriately.

There were sufficient numbers of suitably trained staff to provide the service for patients. Staff worked well together as a multidisciplinary team for the benefit of patients. National guidance was used to provide evidence-based care and treatment for patients. Patients were assessed for pain relief as they entered the unit.

Staff treated patients with dignity, compassion and respect. Patients spoke positively about the care and treatment they had received. Staff provided patients and those close to them with emotional support and comforted patients who were anxious or upset. Staff were confident and competent in seeking appropriate consent.

From April 2014 to December 2014, the service met the national Department of Health target to admit or discharge 95% of patients within four hours of arrival. Key risks and performance data was monitored regularly and remedial action taken when performance shortfalls were identified. A trust-wide complaints and concerns policy included information on how people could raise concerns, complaints, comments and compliments, but we noted complaints about the service weren’t always closed in a timely manner.

There was clearly defined and visible leadership within the service and staff felt free to challenge any staff members who were seen to be unsupportive or inappropriate in carrying out their duties. Staff were proud of the work they did and worked well together for the benefit of patients.

Updated 24 July 2019

We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, provided facilities for patients to access enough to eat and drink, and access to pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. 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. Key services were available seven days a week.
• 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 service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were 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:

• Although staff assessed risks to patients, staff had not received specific training to be able to update the patient’s risk record.

Updated 24 July 2019

Our rating of this service stayed the same. We rated it as good because:

• The service had good systems in place to reduce the risk of avoidable harm to patients. There was a good and open safety culture and staff had a strong emphasis on maintaining safe ways of working.
• There was effective incident reporting practices and learning when things went less than well. The service had suitable processes to identify areas for improvement and these were followed up to ensure improvements were achieved.
• The service had low levels of patient harm, they had low levels of infections and falls. These were monitored to ensure risks were acted upon.
• There were sufficient numbers of trained and experienced staff, who were able to meet the needs of patients and reduce the chances of avoidable harm.
• The service reported good patient outcomes and compared favourably against many measures and England averages.
• The service provided care and treatment which was based on evidence based practice and guidance.
• The service had effective processes for multi-disciplinary working, all members of the team provided valuable input into the care and treatment of patients.
• The service ensured patients’ privacy and dignity was protected and they were treated with kindness and compassion.
• The service was able to meet the individual needs of patients in their care such as cultural, psychological and personal differences. Patients were treated as individuals and care was determined with their needs in mind.
• The service provided on the Halton site were planned with the needs of patients in mind. The premises and environment were suitable for the activities undertaken on site.
• Referral to treatment times into the service were better than England average times.
• Leaders were competent and capable, were well respected and supportive of staff.
• The service had good governance and performance management structures in place which enabled them to understand the service, any risks and potential for improvement. This enable them to implement new ways of working and new initiatives which staff were engaged in.

Updated 27 November 2017

We rated urgent care services as good  because:

The urgent care centre had processes in place to reduce the risk of harm to patients. There was learning from incidents and staff had been trained to appropriate safe-guarding levels.

Staff worked to guidance from the National Institute of health and Care Excellence (NICE) and compliance was audited. There was multi-disciplinary working and staff were competent. The department was meeting the Department of Health target for the four hour wait.

There was strong leadership and there were governance structures in place that supported the work of the department.

Staff were caring and there was good feedback from patients about the work of the department.