South Newton Hospital in Salisbury has been rated inadequate overall, following an inspection by the Care Quality Commission (CQC) in January this year.
South Newton Hospital is an independent specialist service for the assessment, treatment and rehabilitation of adults with neurological conditions, including acquired brain injury and progressive neurological disorders. The service, which is run by Renovo South Newton Limited, provides NHS-funded services for up to 17 patients from across the south of England.
CQC carried out an announced comprehensive inspection of rehabilitation services at the hospital in response to concerns about ongoing risks, and because the location had not had a comprehensive inspection since it was registered in January 2020.
Following the inspection, the service is rated inadequate overall and inadequate for being safe and well-led. Caring is rated as good and responsive is requires improvement.
Cath Campbell, CQC’s head of hospital inspection, said:
“When we inspected South Newton Hospital, we found that staff were focused on the needs of patients and were kind, compassionate and respectful when caring for them. However, we had concerns about how the service was being run as leaders didn’t have full oversight of all the issues, which could impact on the safe care and treatment of patients.
“Leaders didn’t effectively investigate or share learning from incidents that occurred and make recommendations to reduce the risk of similar incidents happening again. A policy document stated that learning from incidents was shared with staff in specific meetings, but staff confirmed these meetings didn’t take place. So, although staff were raising concerns and reporting incidents, they didn’t receive any feedback on how these were being dealt with.
“In addition, the service didn’t always recognise safeguarding concerns and report them appropriately. For example, one person complained that a member of staff had removed a whistle so it was out of reach from someone who used this as their primary mode of calling for help. While this incident was investigated internally, there was no evidence that a safeguarding referral was made.
“We were also concerned that the service was not doing everything possible to protect patients from the risk of contracting COVID-19. During our inspection, staff were not using enhanced personal protective equipment such as masks and gloves for patients undergoing procedures such as a tracheotomy, or cough assist, which is used to help clear a person’s airway. They had also not considered the additional challenges of detecting COVID-19 symptoms, such as a loss of taste or smell, in patients who have neuro disabilities or brain injuries.
“We have now told the provider that it must make a number of improvements and we will continue to monitor the service to ensure that these are made and fully embedded.”
CQC found the following during this inspection:
- The service did not meet legal requirements relating to safe care and treatment, infection control, safeguarding and good governance
- Leaders did not fully understand the challenges the service faced. The leadership team had plans to develop the hospital but there was no evidence to demonstrate how the strategy was being delivered or action plan to achieve the strategy, which included effects of the pandemic and local health economy factors
- The service did not operate effective governance systems to improve the quality of care
- Leaders did not always recognise safeguarding concerns and respond effectively or ensure staff were trained to the appropriate level
- Leaders did not always rate the severity of risks accurately or review the risk register regularly
- Staff did not always keep accurate records of patients’ care and treatment. Records were not clear, up-to-date or easily available to all staff providing care
- Incidents were not always effectively investigated to reduce the risk of potential harm from similar or repeated incidents. Not all staff were able to describe what lessons were learnt from the incidents they reported. They were not always aware of any changes to practice to prevent incidents from happening again
- Patients and staff are were at increased risk of exposure to COVID-19 as leaders did not regularly update infection control policies and procedures or complete infection control audits
- The service did not always use systems and processes to safely administer and record the use of medicines
- The service did not respond in a timely way to mental health risks and review mental health risk assessments to mitigate risks to patient safety
- Staff did not always fully and accurately complete patients’ fluid and nutrition charts. Records were not accurate enough to demonstrate if patients had enough to eat and drink, especially for those with specialist nutrition and hydration needs
- Patients and their families and carers are not actively engaged with or involved in decision making to shape services and culture.
However:
- The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment
- Staff were committed to supporting the individual needs of patients and patients were positive about the care they received
- The service was organised to meet the individual needs and preferences of patients
- New leaders, including a new chief executive officer and board chair, were appointed during our inspection. We saw positive interaction between staff and leaders, with staff describing the hospital’s management as visible, supportive and approachable.
Full details of the inspection are given in the report published on our website.
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