‘A caring organisation ...’
This was how the Care Quality Commission (CQC) described Ashford and St Peter’s Hospitals following their inspection of our hospitals in December. The Trust was rated as ‘Good’ overall which is a fantastic achievement for the Trust, our staff and, most importantly, for local members and patients.
This was the first time we were inspected under the CQC’s new inspection regime, which involves a much more rigorous approach than before, and comes against a backdrop of two-thirds of hospitals having been rated by the CQC as requiring improvement.
OPAL (Older People’s Assessment and Liaison) Team
“A good place to come and get your care”
Overall the CQC described our hospitals as ‘a good place to come and get your care’ which, in today’s post Mid-Staffs landscape, is significant and should be seen as very reassuring for patients and their families.
“Outcomes here are generally better than elsewhere”
In their report the CQC noted that ‘all services were found to be effective’ with better than average outcomes. They also noted that ‘care and treatment is delivered by trained and experienced medical staff and committed nurses’ with services accurately following national guidelines, practice and directives.
A number of areas were highlighted as areas of outstanding practice - see opposite - including how we care for patients nearing the end of their life, good team working and how well we use electronic patient records to improve care.
The CQC carried out their in-depth inspection during the first week in December, at probably our busiest time of the year. The three day visit consisted of a team of some 40 inspectors who visited services and departments across our two hospitals, speaking at length to staff, patients and visitors.
The CQC can rate hospital trusts as Outstanding; Good; Requires Improvement; or Inadequate.
The full reports can be found online at: www.cqc.org.uk/provider/RTK
Trust Chief Executive, Suzanne Rankin: “To receive a ‘good’ rating from the CQC in the current climate, particularly at what was an incredibly busy time in the middle of winter, should not be under-estimated. Under the new tougher inspection regime a ‘good’ rating is by no means standard. This is a fantastic achievement and I am really proud to lead such an outstanding and committed team.”
Overall Ashford Hospital received a ‘Good’ rating, with St Peter’s rated as ‘Requires improvement’ largely relating to staffing shortages and difficulties achieving the four hour waiting target for our emergency patients.
Our Early Supported Discharge Team
As well as an overall rating the CQC provides individual ratings on 5 key elements looking at whether the Trust is safe, caring, effective, responsive and well-led.
Safety as a priority
Under the safety domain, the Trust was rated as Requires Improvement which relates predominantly to staffing shortages and having the right number of skilled permanent staff in place.
Feeding back to us at the Quality Summit, the CQC made it very clear that they are not saying our hospitals are unsafe; rather that safety can be improved. Importantly the CQC commented that quality and safety were clearly a priority from the executive level down, and specifically picked out our positive reporting culture.
The first baby born at the Abbey Birth Centre
Recruitment and retention
However, we know we have difficulties in recruiting a number of staff groups, nurses and middle grade doctors in particular, and whilst we fill gaps with agency or bank staff, we recognise that is not as good - or as safe - as having staff who are permanent members of the team.
We are already actively progressing different recruitment strategies but it's clear we need to be even more creative about how we do this. It is an absolute priority for us.
We have already started to develop a recruitment branding strategy, seeking to promote Ashford and St Peter’s as a caring, family-friendly Trust where staff can develop their long-term careers.
Areas of good and outstanding practice
- Our specialist OPAL (Older People’s Assessment and Liaison) Team, offering effective management and support to our older, frail patients early in their admission to hospital. The team are helping to prevent unnecessary hospital admissions and to reduce readmissions.
- The electronic patient record system in the intensive care unit which allows patients to benefit from comprehensive, detailed records in one place. Also highlighted in critical care was an outstanding handover session between the consultants going off duty and those coming on shift.
- Our dinosaur trail distracting children on their way to theatre.
- The CQC highlighted the way we care for patients at the end of their lives as outstanding, noting good joint working between our wards, Chaplaincy and Bereavement services in particular, to ensure dignity and respect at all times.
- Our Early Supported Discharge Team, helping reduce patients’ length of stay in hospital following orthopaedic surgery. The team gives patients continuity of care by supporting them in their own homes following discharge, helping to promote a speedier recovery.
- The Abbey Birth Centre which, although relatively new, was already reporting improved outcomes for reduced uptake of pain relief, mobility in labour, less use of drugs for bringing on labour and fewer operative deliveries.