Wharfedale General Hospital

Updated 25 August 2022

We last inspected this service in February 2019. During the last inspection, the service was rated as good overall and good in all key questions apart from safe which was rated as requires improvement. We issued two requirement notices in relation to regulation 12, safe care and treatment.

We carried out this inspection because of an increase in the reporting of safeguarding concerns and because of intelligence about the provider, Villa Care Limited.

Bilberry and Heather wards at Wharfedale Hospital are operated by Villa Care Limited who provide nursing care to patients under a service level agreement with a neighbouring trust. At the time of this inspection the wards were operating to a capacity of 48 patients. The majority of the beds were occupied.

Patients admitted to these wards were medically optimised for discharge from acute hospital wards. The provider worked with the local clinical commissioning group (CCG) to ensure patients received and could access care and treatment from a multi-disciplinary team of professionals, some of whom are employed by the trust such as therapy staff. Medical cover was provided by local GP’s in accordance with agreed contracts.

What people who use the service say

We spoke with 7 patients and three carers.

Patients told us that overall they were happy with the care and treatment that they received. They said they felt safe and had their needs met. They said that staff worked hard but sometimes they had too much work to do to be able to respond as quickly as they might hope.

Patients said the food on the wards was okay but sometimes it arrived lukewarm. They said they could get drinks and snacks when they wanted.

Patients also said that they did not know much about their discharge plans and they said that they would like to be more involved in this process.

Carers told us that they were very impressed with the care and treatment that the staff delivered. We were told the wards were always very clean and well looked after. Two of the carers we spoke to said that it was the best treatment that they had ever experienced for the people they cared for.

One carer said it was sometimes difficult to contact the wards by phone but whenever they were on the wards staff worked hard to keep them informed about those that they cared for.

Updated 25 August 2022

Our overall rating of this service went down. We rated this service as requires improvement.

We rated the service requires improvement overall because:

• Staff and managers could not demonstrate that they understood and effectively managed the use of Deprivation of Liberty Safeguards.
• We observed a lack of meaningful activities taking place on the wards and nearly all patients remained in their night clothes throughout the day without any encouragement to get dressed.
• Staff did not store or dispose of medication and emergency medical equipment safely and securely.
• There were no robust arrangements in place to provide clinic oversight of the administration of medicines.
• The process for sharing lessons learnt with all staff was not robust. It was therefore difficult to evidence if this process was effective.
• Care plans, discharge plans, risk assessments and risk management plans lacked detail and personalisation. Care records were stored in different places using a combination of paper and electronic systems. This made it difficult to ensure that all staff were supporting patients consistently.
• Patients told us that they did not know what their discharge plans were and what goals they needed to achieve to work towards their discharge.
• Capacity assessments in relation to bed rails appeared to lack any detail, personalisation or input from patients. The use of bedrails was common practice and lacked rationale.

However:

• All ward areas were clean, well-furnished and well maintained.
• We received positive feedback from patients and carers. They said staff were kind and caring and worked hard to meet people’s needs.
• Staff had undertaken all elements of mandatory training to ensure that they could deliver care safely.
• Leaders were visible and approachable, and staff felt they had the right support.

Updated 25 August 2022