Worthing Hospital

Updated 14 February 2024

Worthing Hospital is one of the hospitals of University Hospitals Sussex NHS Foundation Trust and provides clinical services to people living in and around Worthing.

At this inspection we inspected the surgery and medical care core services at Worthing Hospital. We found there was a deterioration in the quality and safety of the surgery and medical care services since the last inspection in 2016, resulting in a drop in their ratings. The change in rating of the surgery and medical care services at Worthing Hospital has affected the overall rating of the hospital, which has dropped to requires improvement. More detail about the findings and required improvements can be found in the core service sections of this report.

Updated 14 February 2024

Updated 20 April 2016

The children and young people’s service was rated 'Outstanding' because it had a strong, open culture of safety developed through the reporting and learning from incidents and complaints. Strong governance and an effective assurance framework resulted in a cycle of monitoring and improvement. 

The children and young people who used the serviced experienced good care that resulted in outcomes generally above national benchmarks. Where there was underperformance, it was recognised and addressed through robust action. Staff knew how the service was performing in specific areas and were motivated to make improvements.

Innovation and ownership of the service was strongly encouraged. There was a culture of joint working and learning from others. This worked across the trust with examples such as 'Harvey’s Gang' (which the trust is justifiably proud of) and with other local providers and children’s agencies. The result of this was children and families had a seamless journey through separate services, both internally and externally.

Outcomes for very young children living in challenging circumstances benefited from this joint working. Most importantly staff and leaders of the service were self-aware, knew the limits of care they could provide safely, understood areas they needed to improve on and were working on these. They were very proud of their work and felt sufficiently comfortable in their position to share their pride widely and loudly to build on their strengths.

Updated 22 October 2019

Our rating of this service improved. We rated it as outstanding because:

• Leadership was compassionate, inclusive and effective. Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. Leaders had the skills, knowledge and experience to perform their roles.
• Leaders and staff had a deep understanding of issues, challenges, priorities and vision for their service. The strategy places patients’ safety and individual needs at the core of its strategy.
• There was strong collaboration, team-working and support across all functions and a common focus on improving the quality, safety and sustainability of care. Staff are proud of the organisation as a place to work and speak highly of the culture. Staff at all levels are actively encouraged to speak up and raise concerns.
• There was a strong visible person-centred culture to providing care in the critical care unit. Patients were treated with dignity and respect at all times. All staff we spoke with were very passionate about their roles and were dedicated to making sure patients received the best individualised patient-centred care possible.
• Staff understood the impact that a person’s care, treatment or condition had on their wellbeing and on those close to them, both emotionally and socially. People's emotional and social needs were seen as being as important as their physical needs.
• Staff involved patients and those close to them in decisions about their care and treatment. Relatives of patients told us they felt involved in decisions. We observed staff communicated with patients and their relatives in a way which they could understand, and they asked patients if they understood what had been discussed.
• All staff were actively engaged in activities to monitor and improve quality and outcomes (including, where appropriate, monitoring outcomes for people once they have transferred to other services). Opportunities to participate in benchmarking and peer review are proactively pursued, including participation in approved accreditation schemes. Outcomes for people who use services are positive, consistent and regularly exceed expectations.
• The continuing development of the staff's skills, competence and knowledge was recognised as being integral to ensuring high-quality care. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills, and share best practice. Managers made sure staff received any specialist training for their role.
• Staff, teams and services were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care to people who use services.
• The service was inclusive and took account of patients’ individual needs and preferences. There was a proactive approach to understanding the needs and preferences of different groups of people and to delivering care in a way that meets these needs, which is accessible and promotes equality. This included people with protected characteristics under the Equality Act, people who may be approaching the end of their life, and people who are in vulnerable circumstances or who have complex needs.
• Governance arrangements were proactively reviewed and reflected best practice. A systematic approach was taken to working with other organisations to improve care outcomes.
• There was a fully embedded and systematic approach to improvement which made consistent use of a recognised improvement methodology. Improvement was seen as a way to deal with performance and for the organisation to lean. Improvement methods and skills were available and used across the service and staff were empowered to lead and deliver change.
• The service managed patient safety incidents well. Staff recognised incidents and near misses and reported them appropriately. 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. Managers ensured that actions from patient safety alerts were implemented and monitored.
• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix.
• The service had enough medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed staffing levels and skill mix.
• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix.
• Staff understood how to protect patients from abuse. Staff understood their responsibilities and the steps to take in the event of a safeguarding concern. Staff had training on how to recognise and report abuse, and they knew how to apply it.

However:

• The high dependency unit did not meet the minimum bed space dimensions as recommended in national guidance
• Safety thermometer data was not displayed. to keep patients and visitors informed about the units performance.

Updated 20 April 2016

Staff provided an end-of-life care service that was outstanding. The specialist palliative care team, mortuary and chaplaincy team worked effectively and cohesively to provide a seamless service. Most audits performed by Worthing Hospital scored above England averages, which underpinned the rating given for this service.

The management structure, staff involvement and culture of the service were good. Patient and staff feedback was consistently positive throughout the inspection. There was a positive vision for the future sustainability of the service.

Updated 29 July 2022

Updated 15 May 2023

Updated 22 October 2019

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

Updated 14 February 2024

Updated 20 April 2016

Overall, we rated the emergency department as 'Outstanding'. It wasn't perfect but the staff and trust executive knew where any shortfalls and risks were and were constantly reviewing the provision to ensure it was meeting the needs of the people using the service.

Departmental leaders and staff had implemented systems to maintain flow and escalate problems as soon as there were indications of delays in patient flow. The trust had programmes of work to improve patient flow through the hospital. The hospital met the national target of seeing, treating, admitting or discharging 95% of patients within four hours, ending the year in the top 20 trusts in the country.

We saw examples of a service that responded in an extremely compassionate way to meet the needs of a patient whose spouse had died the previous day in the same department. The service was very busy but the patient and their relatives were made to feel as though staff had all the time in the world to support and care for them.

Patients were asked about their wishes and were supported to make decisions about their care and treatment. We saw staff consistently offered care that was kind, respectful and considerate whilst promoting their privacy and dignity at all times. Staff supported patients promptly in managing pain and anxiety and we observed staff discussing treatment and pain management with patients in ways they could understand.

The ED had a strongly embedded culture of learning from incidents. There were clear and effective processes for incident reporting, investigation and learning from incidents. Staff we spoke with knew how to escalate concerns in relation to patient safety and safeguarding. They were aware of Duty of Candour and could describe how they met this requirement.

The leaders of the service were well respected by the staff. Staff of all grades and disciplines talked positively about working in the department and for the trust.