Stracathro Hospital May 17

“During our inspection of Stracathro Hospital we found both areas of good practice and areas to improve. Interactions between staff and patients were positive and all patients praised the care they received.

“However NHS Tayside must ensure that all older people, who are being treated in accident and emergency or are admitted to hospital, are assessed within the national standard timescales. This is to include frailty, cognitive assessment and nutritional screening and assessment.

“We will continue to monitor the situation and will follow up on these at future inspections.”

Ian Smith, Senior Inspector

Stracathro Hospital

Older people in acute hospitals inspection unnanounced inspection

Inspection dates: 21 - 22 February 2017

Summary of inspection

Stracathro Hospital is a general hospital in Angus. It has 40 beds and provides services including outpatients, stroke rehabilitation and medicine for the elderly assessment and rehabilitation. These services are the responsibility of Angus Health and Social Care Partnership.

Stracathro Regional Treatment Centre (SRTC), an acute elective surgical unit, is located within the grounds, as well as the psychiatry of old age unit. The SRTC caters for patients from Grampian, Tayside and Fife NHS board areas and is part of acute services in NHS Tayside.

We carried out an unannounced inspection to Stracathro Hospital from Tuesday 21 to Wednesday 22 February 2017 and we inspected the following areas:

  • stroke/rehabilitation ward
  • Medicine for the Elderly Assessment & Rehabilitation Ward, and
  • the SRTC.

Before the inspection, we reviewed NHS Tayside’s self-evaluation and gathered information about Stracathro Hospital from other sources. This included Scotland’s Patient Experience Programme, and other data that relate to the care of older people.

We also carried out an NHS board visit to NHS Tayside on 4 June 2014. Based on our review of this information, we focused the inspection on the following outcomes:

  • treating people with compassion, dignity and respect
  • screening and initial assessment
  • person-centred care planning
  • safe and effective care
  • managing the return home
  • leadership and accountability, and
  • communication.

During the inspection, we:

  • spoke with staff and used additional tools to gather more information. In all wards, we used a formal observation tool and the mealtime observation tool, where appropriate. We carried out two periods of observation and, in each instance, members of our team observed interactions between patients and staff in a set area of the ward for 20 minutes.
  • carried out patient interviews and used patient and relative/carer questionnaires. A key part of the public partner role was to talk with patients about their experience of staying in hospital and listen to what was important to them. We spoke with nine patients during the inspection and received completed questionnaires from eight patients. We did not receive any completed relative/carer questionnaires.
  • reviewed nine patient health records to check the care we observed was as described in the care plans. We reviewed all patient health records for cognitive impairment, food, fluid and nutrition, falls, and pressure ulcer care.

We also reviewed the patient health records for do not attempt cardiopulmonary resuscitation forms and medicines reconciliation.

We would like to thank NHS Tayside and in particular all staff at Stracathro Hospital for their assistance during the inspection.

Areas of Strength

We noted the following areas where NHS Tayside was performing well in relation to the acre provided to older people in acute hospitals.

  • All patients praised the care that they had received.
  • DNACPR documentation was well completed.
  • Good evidence of reassessments following transfer to Stracathro Hospital.
  • Good mealtime management.

Areas for improvement

We found that further improvement is required in the following areas.

  • Documentation, such as care rounding sheets, fluid balance charts, food record charts and SSKIN bundles, were not always accurately completed.
  • The completion of person-centred care plans was variable. These should detail the interventions required to meet patients’ identified care needs, but not all care plans reviewed did.
  • There were some concerns around the completion of the assessment of capacity to consent and staff understanding of Adults with Incapacity documentation.

 

This inspection resulted in six areas of good practice and eight areas for improvement. A full list of the areas of good practice and areas for improvement can be found in Appendices 1 and 2, respectively on pages 25 and 26.

We expect NHS Tayside to address all the areas for improvement. The NHS board must prioritise those areas where improvement is required to meet a national standar

'The improvement action plan for this inspection has now been removed from the Healthcare Improvement Scotland website, as the inspection took place more than 16 weeks ago. Please contact NHS Tayside for further information on progress against the action plan'.

 

 

Published Date: 4 May 2017

Scrutiny

Stracathro Hospital overview

Find out more about this hospital, including the latest inspection report, on the Stracathro Hospital overview page.

Types of inspections

Inspections may be announced or unannounced and will involve physical inspection of the clinical areas, and interviews with staff and patients. We will publish a written report 8 weeks after the inspection.

  • Announced inspection: the service provider will be given at least 4 weeks’ notice of the inspection by letter or email.
  • Unannounced inspection: the service provider will not be given any advance warning of the inspection.
  • Follow-up inspection: the NHS board and hospital may or may not be given advance notice of the inspection. A safety and cleanliness follow-up inspection will take place no later than 26 weeks from the publication of the initial report.