Archived: Corby Community Hospital

Corby Community Hospital was one of three community hospital sites where Northampton General Hospital NHS Trust provided services on an inpatient ward. Corby Community Hospital Inpatient Ward was a 22-bedded ward providing rehabilitation following discharge from the acute hospital, Northampton General Hospital. The hospital also provided a service for patients with subacute medical conditions who required 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 hyper acute 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 Danetre Hospital.

We found the medical service on the inpatient ward at Corby Community 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. They followed national and best practice guidelines. There was good multidisciplinary team working throughout the ward and with trust specialist teams across the trust. Outcomes for patients were good.

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 staff nurses. The trust was in the process of recruiting more staff. A consultant specialist in the care of the older person  visited the ward twice weekly for a ward round and multidisciplinary team meeting. In addition, a full-time staff grade doctor worked Monday to Friday 9am to 5pm. In addition to this, the urgent care centre, based on the Corby site, provides doctor cover from 5.30pm to 8pm Monday to Friday and then on Saturday and Sunday also from 8am to 8pm. Outside these hours and at weekends, the countywide ‘out of hours’ service was called to support the medical needs on the ward.

There were arrangements in place for the safe administration and handling, storage and recording of medication. However, there had not been an allocated pharmacist on 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 before the inspection and also checked on a range of patient feedback and survey information. We spoke with patients and a relative during the inspection who reported they were happy with care and treatment. The relative praised the staff highly and, despite living some considerable distance from the hospital, had been kept fully informed and involved.

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 been given 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’.