England’s Chief Inspector of Hospitals has rated the services provided by City Hospitals Sunderland NHS Foundation Trust as Good, following an inspection by the Care Quality Commission.
A team of inspectors visited Sunderland Royal Hospital in April and May, inspecting the emergency department, medical wards, surgery and maternity. They also looked specifically at management and leadership to answer the key question: Is the trust well led?
Overall the trust has been rated Good for being effective, caring, responsive and well-led, and Requires Improvement for safety.
The Chief Inspector of Hospitals, Professor Ted Baker, said:
“At their last comprehensive inspection in September 2014, City Hospitals Sunderland NHS Foundation Trust was rated as Good. I am pleased to note the improvement in responsiveness across the trust and that the trust retains its overall rating.
“We found that access to services was generally good and that there were positive examples of collaborative work to respond to the needs of patients when being discharged or transferred from hospital. It was encouraging to see that the average length of stay was lower than the national average for some patient groups
“However we have informed the trust that they must ensure there are enough qualified and experienced nurses and doctors on the wards in order to deliver safe care for patients.“
Across the trust the rating for safety remained Requires Improvement.
There had been consistently low levels of nurse staffing on some wards. Infection prevention and control policies were not always followed and inspectors saw some nursing and medical staff wearing false nails and were not bare below the elbow. Additionally, there was inconsistency around medicines management.
The rating for effectiveness remained as Good. There were good examples of the trust learning from and implementing best practice and positive examples of multidisciplinary working in all the clinical areas. Wards and clinical areas had taken part in national, local and regional audits and used the results to improve patient outcomes.
The rating for caring also remained Good. Inspectors saw staff go further than might be expected to provide care and support. Discussions between staff and patients were carried out in a compassionate and supportive way; staff provided reassurance and information appropriate for the individual patient and their family.
The rating for being responsive improved from Requires Improvement to Good. Services were planned to meet the needs of patients; pathways were in place across clinical areas to meet individual needs. Some environments had been designed or adapted to meet the needs of patients, including patients with additional needs such as those living with dementia or patients with learning disabilities.
Under well led, the trust has been rated as Good. Inspectors found the executive leadership team had an appropriate range of skills, knowledge, and experience. The team understood the challenges to quality and sustainability of services for patients. There was a clear vision and set of values, and inspectors saw quality and sustainability of care were given priority.
During the inspection CQC observed some outstanding areas of practice, including:
- In the Emergency department Staff had developed a new technique and equipment to replace shoulder dislocation. The new procedure was quicker, required less medication or sedation and had been found to improve recovery times for patients
- In medicine the service had developed a ‘delirium and dementia outreach team’ to support the needs of patients and their families.
- In surgery; The introduction of a day of surgery admissions unit had speeded up patient flow for urology and ear, nose and throat (ENT) patients
- In Maternity staff engaged effectively with a local charity to supply a well-equipped bereavement room for use by families experiencing pregnancy loss. In addition, there was a counselling room in the antenatal clinic.
CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Good for using its resources productively.
The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Good
I am pleased to note the improvement in responsiveness across the trust and that the trust retains its overall rating
CQC’s Chief Inspector of Hospitals, Professor Ted Baker