During this inspection we visited outpatients, pre assessment, operating theatres, the intensive care and high dependency units, the day case unit and inpatient wards. Patients we spoke with said their care was “excellent”, that they were "happy with the information they’d been given pre operatively" and that care was “second to none”.

We looked at patient records in the areas we visited and saw that these were comprehensive and fully completed.

Most patients we spoke to were happy with the food provided at the hospital. They told us they had been given an appropriate choice over what they could eat and drink.

All parts of the hospital we saw during our visit were clean and we observed staff complying with good practice for the prevention and control of infection.

Both patients and visitors considered there were enough staff to meet the needs of patients and we saw that staffing was planned according to patients’ needs. Staff considered they had good quality training and felt confident in their roles and tasks.

The Trust had a number of systems in place to gather record and evaluate the quality of services provided. These included systems to help staff identify risks to patients and develop strategies to manage risks and areas of concern. Patient feedback was collected and analysed to seek ways of improving the experience of patients. Clinical audits were carried out regularly on the units.

The majority of patients and relatives we spent time with said that their experience had been very positive, staff were always polite, treated them with respect and all were satisfied with their overall care. Some comments were, "I have been treated with dignity and respect by all staff" and "The medical care and attention given to me has been excellent".

This section was not completed for this inspection. More information about what we found during the inspection is available in the report below.

Our rating of services stayed the same. We rated the hospital as good because:

We rated safe, effective, caring, responsive and well-led as good.

Our rating for surgical services improved to outstanding. We rated safe and responsive good and effective, caring and well-led as outstanding.

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

• The hospital controlled infection risk well and used innovative approaches to reduce the rate of surgical site infections. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection. Key performance information reflected this.

• The hospital managed patient safety incidents well. Services were committed to an open safety culture where all safety issues raised by staff and patients were highly valued. Staff recognised incidents and near misses and reported them appropriately.

• The hospital continued to provide care and treatment that was planned and delivered in line with current evidence-based guidance, standards, best practice, legislation and technologies. There continued to be a truly holistic approach to assessing, planning and delivering care and treatment to people who use the service.

• Staff gave patients enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary. The service made adjustments for patients’ religious, cultural and other preferences.

• The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service. We saw that staff were supported to maintain and further develop their professional skills and experience. We saw that practice educators were available in each ward and department to support staff.

• Staff of different kinds continued to work together as a team to benefit patients. Staff, teams and services were committed to working collaboratively and found innovative and efficient ways to deliver joined-up care to people who used services. For example, we saw the surgical service were split into care groups which were structures to involve MDT working. All relevant staff, were regularly involved in assessing, planning and delivering patients care and treatment. Staff worked well together to understand the range and complexity of people’s needs. There was a holistic approach to planning patients discharge, transfer or transition to other services which was started at the earliest possible stage.

• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

• Staff continued to involve patients and those close to them in decisions about their care and treatment.

• The trust planned and provided services

  , amenities and care

  in a way that met the needs of all people

  using the service locally and nationally including patients and their families.

• The service took account of patients’ individual needs in a holistic manner including mental, emotional and social care needs.

• Managers at all levels in the trust had the right skills and abilities to run a service providing high-quality sustainable care.

However,

• The hospital provided mandatory training in key skills to all staff. Compliance for nursing staff within surgical service was generally good and met the trust target, however, medical staff completion was below the trust target and there was a low completion rate of basic life support training.

• There was no standardised procedure within surgical services to ensure medicines and equipment used for organ retrieval were checked and re stocked within surgical service. Although staff told us this was a task completed at the beginning of every shift there was no assurance and no way of knowing if the bag had been tampered with.

Written patient information was not available in other languages and formats suitable for patients with sensory disabilities such as blindness