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CQC Report 

Our Improvement Journey

Following our routine inspection in December 2015 the Care Quality Commission (CQC) has rated the overall care and effectiveness of services we provide as Good.

The inspection team assessed eight core services against the five domains of safe, effective, caring, responsive and well led, with the Trust rated as Good in 27 of the 39 elements. Medical care, maternity and gynaecology, end of life care, and outpatients and diagnostics were all rated overall as Good.

While the inspection team identified areas of good practice across many parts of our services, the overall rating for the Trust was still Requires improvement, reflecting the rating given to the majority of Trusts inspected under this new rigorous inspection process.

The report acknowledges the overwhelming view of our patients and relatives on the care we provide and that the majority of feedback was “extremely positive” The inspection team also praised the positive culture in the Trust where our staff provide kind and compassionate care, which is delivered in a respectful way.

The CQC found a strong culture of reporting and learning from incidents with an emphasis on being open. Our bereavement facilities coupled with sensitive care, good support for patients with dementia and appropriate monitoring of patients whose condition had deteriorated were among other positive findings.

The CQC did identify areas for improvement and, while we had already started to respond to many of the challenges, this provides the focus for our improvement journey, together with our partners in health and social care.

Staffing

Ensuring we have the right number and mix of staff across all services. This is a challenge for nearly all hospital across the country and we acknowledge that the use of temporary staff to ensure safe staffing levels on wards is currently an issue for the NHS.

What we have done

  • As part of active recruitment in Europe over the last three years we now have around 100 nurses currently employed from the continent
  • We have had a greater presence at recruitment fairs, schools and colleges, and on social media and through a dedicated local newspaper campaign
  • We have promoted programmes for return to practice nurses and provided opportunities for existing nursing assistants who are already working with us to further their careers
  • We now offer the Level 2 Clinical Healthcare Support apprenticeship, which once complete, is enough to gain entry to the Open University degree programme for nursing
  • We have successfully bolstered the nurse bank to help with staff deployment and ensure safe staffing levels
  • Promoted staff benefits such as childcare support, staff health and wellbeing initiatives and on-site leisure facilities

What we are doing and plan to do

  • Undertake further recruitment overseas throughout 2016/2017and beyond and carry on with local and national recruitment campaigns
  • A skill mix review is underway and rapid changes in priority areas have already been made
  • Review areas where children are cared for to ensure staff have the relevant specialist skills where appropriate

Patient flow

With increasing pressure on NHS services nationally, maintaining a smooth patient journey through hospital services and into the community where there is adequate support, remains a challenge for all hospitals

What we have done

  • Increased funding for nursing in A&E
  • Redeveloped Surgical Assessment Unit so that patients can assessed faster and discharged
  • In conjunction with our partners in health and social care, we have introduced a Home First scheme to improve the discharge of patients who have ongoing needs
  • Developed a multi-professional Integrated Discharge Team (IDT) to improve discharges at admission where appropriate

What we are doing and plan to do

  • Support the work with our partners to reduce avoidable admissions to hospital
  • Continuing to work with health and social care on early discharge planning
  • Continuing to work with our partners on demand management to ensure patients receive treatment in the right place at the right time.
  • Work with our partners to reduce delayed transfers of care – where patients who are medically fit to be discharged, but need further care in an appropriate community setting
  • Make better use of our “Green to Go” initiative where each patient is given a colour coded rating that indicates their clinical readiness for discharge.
  • Introduce an electronic whiteboard system that will help staff with ward level decisions and improve patient flow.

Caring for patients with mental health needs

While the Trust provides general and emergency care it is important that patients who present with mental health problems have access to specialist care. The Trust also did not always receive a responsive service from an external mental health provider team to support patients who presented in A&E with mental health problems.

What we have done

    • We have reviewed how we assess and care for patients with mental health needs
    • Provided specialist training on Mental Capacity Act for all staff
    • Reviewed access to mental health provision where patients present at “crisis point” in A&E

    What we are doing and plan to do

    • Extend the hours of the adult mental health liaison service
    • Work with specialist mental health partner to further improve access to mental health provision out-of-hours

    We know that our staff work hard to provide good quality care for our patients and should be proud of the work that they do for our local community, in what are difficult and challenging times for the NHS.

    A detailed action plan is in place to continue the improvements we have already started to make in areas identified within the report and we will continue to work closely with our colleagues within the local healthcare system.

    Cara Charles-Barks

    Chief Executive

    Salisbury NHS Foundation Trust

    Page Last Updated: 15/02/2017 07:45 
    Printed from Salisbury NHS Foundation Website http://www.salisbury.nhs.uk