Salford Royal NHS Foundation Trust is awarded Outstanding rating by Chief Inspector of Hospitals

England’s Chief Inspector of Hospitals has rated Salford Royal NHS Foundation Trust as Outstanding following an inspection by the Care Quality Commission.

Inspectors rated Salford Royal Hospital as Outstanding with its accident and emergency (A&E), medical care, and end of life care each being rated as Outstanding.

The trust’s community services have been rated as Good overall, with community health services for adults and community end of life care rated as Outstanding. CQC found that the trust had a strong safety culture and the concept of providing safe, harm free care was considered a priority for staff at all levels. Learning from incidents was widely shared across the trust and staff recognised the importance of reporting incidents to ensure patient safety.

Wards were well staffed and staff worked flexibly to ensure any shortages were covered. Although agency staff were rarely employed, they received a thorough induction to ensure they were familiar with their working environment.

There was consistent evidence of quality improvement undertaken by the trust to meet the needs of their local population. All wards had a dementia champion. A blue butterfly symbol had been introduced to identify patients with cognitive impairment. Patients identified as such, were visited by dementia specialist nurses who also co-ordinated training for staff members on dementia awareness.

Clinical governance led by the Director of Nursing was highlighted by inspectors as a particular strength. Ward level clinical standards were regularly assessed through the trust’s Nursing Assessment and Accreditation System (NAAS) which measures the quality of nursing care delivered by teams. Each ward gains a rating which is publicised throughout the wards and clinical areas for patients and visitors to read.

In January 2013 the Trust had introduced the concept of ‘always events’, which were things that patients should always expect from the trust, such as patients and carers will always know who is in charge of their care.

Innovative and exceptional community end of life care was provided to care home residents by the trust’s specialist Care Homes Medical Practice. The service was effective in reducing the number of admissions to the acute hospital and allowed frail elderly patients to remain in their preferred place of care until their death.

Inspectors identified a range of areas of outstanding practice, including:

• The trust’s nursing assessment and accreditation system (NAAS), which provided the trust board and patients with a high level of transparency in relation to clinical performance. This information was publicised throughout the wards and clinical areas for people to consider and scrutinise.
• Quality improvement initiatives that had successfully led to a reduction in the number of hospital acquired pressure ulcers.
• The incentive scheme for staff who wished to be involved in helping the trust to make financial savings to the service. If an idea was adopted, the staff member received 10% of the overall savings as a reward for their innovation.
• The follow up of patients after discharge for critical care and the system by which bleeps were provided to relatives in order that they could be contacted quickly by staff if they were away from the Critical Care Unit.
• The diabetes outpatient service which demonstrated good practice where children developing into adulthood were seen in a clinic attended by an adult physician and adult specialist nurses, giving dietetic and psychological support. This ensured a continuous and consistent pathway of care through to adulthood.
• The system of daily safety huddles, and intra-team situation reports ensured that important information was passed between teams and shifts.

Inspectors found that improvements were needed with regards to safety checks undertaken on patients going through operating theatres, and to ensure that outstanding repair work to the outpatient department was completed.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“We have found Salford Royal Hospital NHS Foundation Trust to be providing an outstanding quality of service. Just about all of the people we met on this inspection spoke positively about ensuring that patients received safe, clean and personal care every time.

“There is a clear focus on quality improvement across all staff groups to reduce patient harm, improve outcomes and patient experience, starting even before admission. We found the services were tailored to meet the needs of individual people both in Salford Royal Hospital and across the community, with services providing continuity and integrated care from the hospital into the community.

“The trust sets out to be safest in the National Health Service - and we found that this ambition was understood and embedded in the practice of staff across all professions and at all levels. Members of the senior management team were fully engaged with frontline staff, with strong working relationships between the executive team and the Foundation Trust Governors.

“The challenge now is further improvement. We have identified certain areas which need attention - and I am confident that Salford Royal Hospital NHS Foundation Trust will build on this inspection to ensure that its standards continue to set an example which others can learn from.”

Salford Royal NHS Foundation Trust provides acute services to a population of 240,000 people across Salford and the surrounding areas of Greater Manchester. It serves a wider population for some specialist care including treatment for brain, skin, kidney, bone and intestinal conditions. The full reports on Salford Royal Hospital, the trust’s community services and the trust overall are available on the CQC website here.

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts visited the hospital in January 2015.

Ends

For media enquiries please contact CQC Regional Engagement Manager Kirstin Hannaford on 0191 233 3629. Alternatively, the CQC press office can be contacted on 0207 448 9401 or out of hours on 07789 876508.

For general enquiries, call 03000 61 61 61.