- NHS hospital
Royal Albert Edward Infirmary
Report from 12 August 2024 assessment
Contents
Ratings - Urgent and emergency services
Our view of the service
The urgent and emergency services at Royal Albert Edward Infirmary are provided by the Wrightington, Wigan and Leigh NHS Foundation Trust. We commenced a focused assessment of the urgent and emergency services on 12 February 2024 and carried out an onsite inspection on 5 March 2024. The inspection was unannounced. During the inspection, we spoke with staff, leaders, people who use the service and stakeholders. We looked at care records, policies and other documents relating to the service. The service had a positive safety-focussed culture. Safety incidents and complaints were managed well and lessons learned. Care was planned and organised with people and stakeholders to maintain safety and continuity of care. The service controlled infection risks well. Staff planned and delivered care according to best practice and national guidance. Staff treated people with compassion and kindness. Leaders had the skills and experience to carry out their roles but did not always have resources and space to manage the priorities and issues the service faced. However, during the inspection we identified 6 regulatory breaches where we have told the service it needs to make improvements. We found parts of the service did not have suitable and well-maintained furnishings. Whilst the service had enough nursing and support staff, key risks relating to consultant numbers and availability had not been effectively identified and mitigated. Mandatory training compliance in some subjects was significantly below trust targets. Staff appraisal compliance was below trust targets. The service did not effectively manage risks for patients with sepsis. People did not always receive timely care and treatment. Waiting times and arrangements to admit, treat and discharge patients were worse than national standards across most indicators. Although we found areas of concern at this assessment, until we have assessed more quality statements the rating for this service remains the same.
People's experience of this service
People who use the service, their relatives and carers told us they were treated with kindness, compassion, and dignity by staff. They felt that staff listened to them and communicated with them appropriately, in a way they could understand. They told us they had been triaged and had individual risk assessments that took in to account their specific needs. People told us the waiting area was overcrowded and did not have enough suitable space to accommodate them. Most people we spoke with told us they experienced long waits. They told us more communication about waiting times would be helpful to provide clarity around expectations. People receiving corridor care told us the environment was not appropriate to meet their privacy and dignity needs. However, they acknowledged the difficult circumstances staff were working in and they appreciated the care, kindness and compassion that was shown to them. They also told us staff provided good care and they felt safe within the corridor environment. People who use the service were aware of their treatment plan and who was reviewing their care. People told us their nutrition and hydration needs had been met. They told us they were offered refreshments and meals in a timely manner. People who use the service, their relatives and carers told us the services were clean, tidy, and easily accessible. They felt there were suitable numbers of staff available and staff responded promptly when called. They knew how to raise a complaint or concern.