Peterborough and Stamford Hospitals NHS Foundation Trust was one of the first wave of NHS trusts to be authorised as a foundation trust in April 2004. The trust has approximately 633 beds and over 3,500 staff spread across two sites, Peterborough City Hospital (611 beds) and Stamford Hospital (22 beds). Peterborough City Hospital is a new building funded under the private finance initiative (PFI); it became fully operational only in December 2010, combining services previously supported on three separate sites. It provides acute health services to patients in Peterborough, Cambridgeshire South Lincolnshire, North East Northants and Rutland.
In addition, the trust provides a range of community services including community midwifery and Macmillan nursing. The trust provides rheumatology and neurology services at the City Care Centre and services in support of Sue Ryder in Peterborough, at HMP Peterborough and in local GP practices. We did not inspect these services during this inspection.
The trust has had 10 inspections at its sites since registration in 2010. The most recent inspection took place at Peterborough and Stamford Hospitals NHS Foundation Trust on 10 July 2013, and the trust was found to be non-compliant with most of the outcomes inspected. Peterborough City Hospital was last inspected in April 2013; that inspection found the location to be non-compliant in respect of ‘Outcome 4: Care and welfare of people who use services’ and ‘Outcome 16: Assessing and monitoring the quality of service provision’. These regulations relate to the completion of patient documentation. These were found to be compliant on this inspection.
Stamford Hospital was last inspected in July 2013, when it was found to be non-compliant in respect of ‘Outcome 4, Care and welfare of people who use services’, ‘Outcome 13: Staffing’ and ‘Outcome 16: Assessing and monitoring the quality of service provision’. These relate to the assessment of patients’ needs, completion of care records and adequate staffing being available to provide care. At this inspection, we found that all actions required to address these breaches of regulation had been taken and that both hospitals were compliant.
We found that the trust provided safe, effective and caring services to most of its patients and that it was well led by the senior team, with staff supported by their local managers. However, we found that the trust was not always responsive to the needs of its patients: because of capacity issues, it did not achieve the national targets set in relation to treatment times in the accident and emergency (A&E) department or the times from referral to treatment. This meant that patients’ care was delayed.
Staffing
The hospital was in the process of reviewing the number of staff on every ward and was using the Safer Nursing Tool recommended by the NHS Institute for Innovation and Improvement. The initial review found that most wards were already functioning at the required level of staffing but a few wards needed further assessment of patient acuity (this is the complexity of needs of a patient). At our announced inspection, we found that most wards were appropriately staffed, but we heard that night times were a particular problem with regard to reduced staffing. We returned for our unannounced inspection during the late evening and found that staffing was appropriate to meet the needs of the patients on all the medical wards except one, where a member of staff had called in unwell. This gap was filled by a student nurse and, while this meant that staff were busy, patients remained safe during this night visit. Staffing at Stamford Hospital was appropriate to meet the needs of patients; the ward manager at the John Van Geest unit utilised her staffing budget in innovative ways to meet the needs of patients.
Cleanliness and infection control.
Both hospitals were found to be clean and infection was prevented and controlled through good use of cleaning schedules and monitoring systems. Each ward and department had audits displayed of the numbers of infections that had occurred and staff were aware of the need for good hand hygiene in preventing the spread of infections. However, at Peterborough City Hospital we found that a number of hand gel dispensers were empty and that on occasion people had to walk through several sets of doors to find a dispenser that had antibacterial hand gel in it. Hand gel dispensers at Stamford Hospital were found to contain gel on all occasions.