Southend University Hospital

Updated 27 October 2023

Southend Hospital is operated by Mid and South Essex NHS Foundation Trust. The hospital provides local elective and emergency services to people living in and around the districts of Southend. Medical wards provided by Southend Hospital include elderly care, acute medical assessment, general medicine, stroke, respiratory, gastroenterology, renal, endocrinology and cardiology.

Between January 2022 and December 2022 medical care had 45,835 admissions including 25,327 day cases.

We carried out this short notice announced focused inspection of medical care on 12 July 2023.

The service was rated as inadequate following our previous inspection, in January and February 2023. Following our last inspection, we issued a warning notice under Section 29A of the Health and Social care Act 2008 because of concerns relating to poor governance, incomplete risk assessments, incomplete patient records, equipment not being maintained, patients’ nutrition and hydration needs not being met and medication not being managed in line with the service’s medicines policy.

As this inspection was a focused follow up inspection, we only looked at the key questions of safe, effective and well led. We carried out this inspection to determine whether improvements had been made against the requirements of the warning notice we issued at our previous inspection. Although the service had made improvements against the section 29A warning notice, this inspection did not look at the requirement notices that were issued at the previous inspection. As these requirement notices remain, this meant the ratings were limited to requires improvement.

Our rating of this service improved. We rated the service from inadequate to requires improvement. During this focused inspection, not all breaches identified at the last inspection were reassessed to include all potential improvements.

We found:

• The design, maintenance and use of facilities, premises and equipment kept people safe.
• Staff completed and updated risk assessments for each patient and removed or minimised risks.

• Staff gave patients enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary.
• Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to obtain consent from patients.
• Leaders operated effective governance processes, throughout the service. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

However:

• The service needed to continue to embed processes and evidence this improvement through continued audit.

Updated 27 October 2023

Updated 24 April 2018

Our rating of this service improved. We rated it as good because:

• Staff kept patients safe from harm and abuse. They understood and followed procedures to protect vulnerable children. Staff assessed and monitored patient risk.
• Care was provided in line with national and best practice guidelines. The service participated in both local and national audits to improve patient outcomes.
• Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Staff cared for patients with compassion, treating them with dignity and respect.
• Staff planned and delivered services to meet individual needs.
• The service had governance, risk management and quality measures to improve patient care, safety and outcomes.

However:

• The department did not ensure medical staff completed mandatory training to trust target levels.
• Staff did not consider the personal preferences of young people aged 16 and 17, specifically their preference to be nursed on either an adult or paediatric ward.
• Paediatric waiting lists were long, particularly for autism spectrum disorder (ASD) and epilepsy assessments. The trust was not commissioned to provide this service to children over the age of five; however, they had continued to accept referrals. The trust was in communications with the local commissioners to reduce the waiting list.

Updated 2 August 2016

Effective processes were in place to learn from incidents and staff used learning from incidents and complaints to improve their practice and deliver safer, more effective care. The environment was clean and staff followed infection control procedures. Medicines, including controlled drugs, were safely and securely stored.

Medical and nursing staffing numbers did not always follow guidelines laid down in the Core Standards for Intensive Care Units.

Patients received treatment and care according to national guidelines and best practice. We saw effective multi-disciplinary team working across the units, with good consultant input. Junior doctors were adequately supported to provide safe treatment and assessment. Physiotherapists, dieticians, microbiologists and pharmacists were highly spoken of by CCU staff and were available when needed.

Without exception, staff were complimentary about the leadership on the unit. Managers on CCU and ARCU demonstrated commitment to patient care, delivering a positive patient experience, developing and caring for their staff, robust governance and effective strategic planning.

Updated 23 December 2022

Updated 24 April 2018

Our rating of this service improved. We rated it as good because:

• End of life care improved and has been rated as good overall. The questions of safe, effective, responsive and well-led improved to good. Caring remained the same and was rated as good. The service handled safety incidents well. The service had processes in place to measure their performance. Staff went the extra mile in caring for their patients. The service had a cohesive team and had governance processes in place for the oversight of risk, safety and quality.
• The service managed patient safety well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
• Staff cared for patients with commitment, dignity and compassion. Feedback from patients confirmed that staff treated them well and with kindness.
• The trust planned and provided services in a way that met the needs of local people.
• The trust had managers at all levels with the right skills and abilities to run a service providing high-quality sustainable care.

Updated 23 December 2022

Updated 6 March 2020

Our rating of this service stayed the same. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• People were not always able to access the service when they needed it waiting times were below the national averages. The service did not always close complaints in line with the trust policy. The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 1 December 2021

Updated 1 December 2021