Archived: Danetre Hospital

Danetre Hospital was one of three community hospital sites where Northampton General Hospital NHS Trust provided services on an inpatient ward. Danetre Hospital Inpatient Ward was a 28-bedded ward providing rehabilitation following discharge from Northampton General Hospital. The hospital also provided palliative care, dedicated stroke care and a service for patients who needed an enhanced level of care that could not be provided at home.

Northampton General Hospital NHS Trust was an acute trust with 800 consultant led-beds, and provided general acute services for a population of 380,000. It also provided hyperacute stroke, vascular and renal services to people living throughout the whole of Northamptonshire, which had a population of 691,952. The trust was an accredited cancer centre and provided cancer services to a wider population of 880,000 who lived in Northamptonshire and parts of Buckinghamshire.

Northampton General Hospital NHS Trust also provided services at Isebrook Hospital and Corby Community Hospital.

We found the medical service on the inpatient ward at Danetre Hospital to be generally safe because there were assessment and reporting systems in place to identify risk, take action and learn lessons from incidents and complaints. Staff felt informed about incidents and able to report concerns. Staff followed national and best practice guidelines. There was good multidisciplinary team working throughout the ward and with trust specialist teams. Outcomes for patients were good.

The ward staff operated in three teams each specialising in a field of care; this enabled staff to develop their knowledge and they continually sought ways to improve patient experience; for instance, one team had achieved the Gold Standard for palliative care.

Nurse staffing and patient dependency levels were assessed using a recognised tool. There were vacancies, which were covered either by staff on the ward doing additional hours or by bank and agency nurses. The trust was in the process of recruiting more staff.

There were arrangements in place for the safe administration and handling, storage and recording of medication. However, there had not been an allocated pharmacist to the ward to oversee and review medicine and prescribing arrangements. This meant that patients were at risk of not receiving appropriate treatment, possible medication errors occurring and necessary reviews of medication not taking place. The trust had employed a locum pharmacist who was due to start by the end of January 2014.

Analysis of infection rates in the trust showed them to be within expected limits. The ward was clean and there were arrangements in place for ward cleaning and decontamination of equipment. We found gels, aprons and gloves were in good supply and waste appropriately dealt with. There were assurance mechanisms in place to identify when standards for cleanliness and infection prevention needed improving.

We sought the views of the public at a listening event prior to the inspection and also checked on a range of patient feedback and survey information. We spoke with patients during the inspections who reported that they were happy with the care and treatment on the ward and staff were kind. We saw examples of compassionate care. The local ward results from the Friends and Family Test were consistently good, but staff were not complacent and continued to seek ways to improve patient experience.

There were clear clinical, organisational, governance and risk management structures in operation. Staff had confidence in the ward managers and felt well supported. However, not all staff had completed their mandatory training or had an appraisal. This meant that the trust could not be assured that staff were up to date with their skills and knowledge to appropriately meet patients’ needs. Issues over the lack of a pharmacist for the ward and non-completion of training and appraisals had been known to the trust for a significant time, with insufficient action taken to address the issues.

We found that the trust had breached Regulation 13 (medication) and Regulation 23 (staff support and training) for the regulated activity treatment of disease, disorder and injury.