Bath Hospital surgery services rated Good following inspection
Surgery services at the Royal United Hospital Bath have been rated as Good following an inspection from the Care Quality Commission. The CQC carried out an unannounced inspection of three surgical wards following concerns received about specific wards and the safety and quality of surgery services.
The three wards visited as part of the inspection at Royal United Hospital Bath were Forrester Brown, Pulteney, and Philip Yeoman. Following this inspection, surgical services have again been rated as good overall, and for being safe, caring, effective and well-led.
The area of responsive was not looked at during this inspection and remains rated as requires improvement from a previous inspection. As there have been no rating changes at service level, the overall rating of the hospital remains unaffected at requires improvement, and the overall rating for the trust remains good.
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Neil Cox, CQC deputy director of operations in the south, said: “At Royal United Hospital Bath’s surgery services, we found staff and leaders worked well together to deliver safe, people-centred care.
“The trust had a cultural improvement programme in place, and we saw signs this was helping to make the services a better place to work and providing safer, more effective care. The service had a shared vision and there was a proactive and positive culture of safety among staff.
“We saw staff treat people with kindness and compassion, taking their individual needs into account. Inspectors spoke to several people on the wards and all of them praised staff, noting they were attentive to their needs. One person said nothing was too much trouble for the staff on their ward, and another spoke of their calmness and professionalism. Staff should be extremely proud of the care they’re providing to people using the service
“The service had identified safety risks in the care and environment of the surgical services and were taking steps to mitigate these. They were also auditing how well the service performed to ensure it met the required standards.
“During the inspection we received a complaint about patient confidentiality on Forrester Brown ward. We found space was limited and some staff safety briefings happened in areas where people were being treated, which meant people’s personal information could be overheard. Staff across all wards did their best to close doors and conduct quiet handovers at nurse stations to avoid overheard conversations.
“We identified some small areas for improvement and have told the trust where these are. We will continue to monitor them to ensure they’re building on their good work to make those changes.”
The CQC Inspectors found staff had the right skills and experience. Inspectors saw they were approachable and openly discussed compassionate care, ensuring people with protected characteristics received individualised support. All staff emphasised treating people equally and without judgement. In the Forrester Brown ward, staff had referred someone to the learning disabilities team to ensure they received expertise and individualised care that met their needs.
They added that medicines were generally stored and managed safely. The service audited stock levels and kept good records, while staff understood duty of candour and were open and honest with people when things went wrong.
But they said there were some staff shortages on the Pulteney ward and Philip Yeoman ward during the inspection, although the service had processes in place to mitigate issues caused by a lack of staff. The CQC has also requested an action plan from the trust around some safety concerns. This included how the trust reviewed incidents, fire risk assessments, and auditing how they monitored people’s food and fluid intake and blood clot assessments when people were admitted to the surgical wards.
The report added: “The trust planned to increase the number of professional nurse advocates in the next year. The trust was committed to improving its surgical services to improve the patient experience.
“We were told that there had been a recent bed reconfiguration of the surgical service and the management team felt satisfied that this would help to improve safe care with patients being cared for in the right places. There was a clear induction process which included a code of expectations for employees.
“Feedback from patients across the three wards we visited praised staff responsiveness. Patients told us they were listened to, spoken to in ways they could understand, with staff taking time to talk with them and address any needs promptly. Overall, patients felt confident staff would address any discomfort or distress, with one witnessing a busy staff member comforting a distressed patient.”