Walkergate Park Hospital is one of the hospitals providing care as part of Northumberland, Tyne and Wear NHS Foundation Trust. It is a neuro rehabilitation and neuro psychiatry centre located in Newcastle Upon Tyne. This hospital provides rehabilitation and assessment services on an inpatient, outpatient or community basis, for people with a disability caused by injury or disease affecting the brain, spinal cord or muscles. Walkergate Park Hospital does not provide accident and emergency services, surgery, critical care, children and young people services and diagnostic imaging services.

Northumberland, Tyne and Wear NHS Foundation trust serves a population of approximately 1.4 million, providing services across an area totaling 2,200 square miles and has 832 beds. The trust has operated as a foundation trust since December 2009. Walkergate Park Hospital has 65 beds.

We inspected Walkergate Park Hospital as part of the comprehensive inspection of Northumberland, Tyne and Wear NHS Foundation Trust, which included over 60 sites across Northumberland, Newcastle, North Tyneside, Gateshead, South Tyneside and Sunderland. In addition, the trust provides a number of regional and national specialist services. We inspected Walkergate Park Hospital between 6 and 9 June 2016.

Overall, we rated Walkergate Park Hospital as outstanding. We rated it outstanding for being effective, caring, responsive and well-led, and good in providing safe care.

We rated medical care and outpatient services as outstanding.

Our key findings were as follows:

• The trust had a clear vision, strategic goals and core values to maintain the Centre for Neurorehabilitation and Neuropsychiatry as a centre of excellence, putting patients first in a service focused on safety, quality and pride in the care and treatment provided.
• The service has a very person centred focus and culture. Staff worked in partnership with patients, their families, carers and other stakeholders to ensure that individual needs were met to enable them to be as independent as possible.

• Staff took the time to meet the individual needs of patients and we were given examples of where staff had gone ‘the extra mile’ to make patients’ hospital stay a positive experience. All patient feedback was extremely positive.

• Very effective multidisciplinary working (MDT) in the assessment, planning and delivery of patient care was apparent across services within the hospital.

• Services within the hospital had engaged and worked with a number of third sector organisations and agencies in order to develop their services or offer further information patients and carers. The services had close links with a number of charities.

• Clinics and services were developed to meet individual needs of people. The services were responsive to the needs of patients and carers and involved patients and carers in the care being provided. Outpatients had introduced a number of outreach services in response to patient need. Outreach clinics were either nurse led, consultant led or led by allied health professionals.

• A number of services provided vocational rehabilitation to patients to help them return to employment.

• Service leads and managers were available, visible within the hospital and approachable; leadership of the service was effective, there was excellent staff morale and they felt supported at ward level.

• Staff and patient engagement was seen as a priority with several systems in place to obtain feedback. The hospital had an effective and well established Service User and Carer Forum.

• The hospital was accredited as a specialised level 1 rehabilitation service.

• The hospital had infection prevention and control policies in place, which were accessible, understood and used by staff.
• Patients received care in a clean, hygienic and suitably maintained environment.
• There was adequate personal protective equipment (PPE) such as aprons and masks available to staff. We routinely saw staff using this equipment during our inspection. Patients and carers told us that staff washed their hands and used gloves and aprons.
• The hospital routinely monitored staff hand hygiene procedures and compliance at the time of inspection was high.
• Patients were assessed regarding their nutritional needs using the Malnutrition Universal Screening Tool (MUST). Where necessary patients were referred to a dietician.

• There were effective arrangements for safely managing medicines, including medicines prescribed ‘as required’ and controlled drugs.

• No patient deaths had occurred within the last three years at this hospital. There were review processes in place should a death occur.

We saw several areas of outstanding practice including:

• A well established Service Users and Carers Forum was in place and social activities for service users and their families had been established with the Headway Charity.
• The hospital had established a Brain Injury Group providing opportunities for discussion of a variety of issues such as brain injury and sleep monitoring.
• The Social Therapeutic and Recreational Rehabilitation Team (STARRT) had been developed to promote independence and increase the quality of life of patients through taking part in social and leisure activities.
• The service had adopted best practice in support of the provision of care and treatment, for example ‘Reducing the risk of deep vein thrombosis (DVT) for patients in hospital’, functional independence measure (FIM) and functional assessment measure (FAM) scores.
• The establishment of a spasticity management clinic for individuals with spasticity following a neurological injury.
• The North East Drive and Mobility Service had worked with a number of external agencies to develop the services to service users, for example the Driver and Licensing Authority and the local police.
• Staff in outpatients had worked with a local university to develop a short course on the holistic management of spasticity and hypertonia. This was developed because a need for training was identified by staff.
• The hand hygiene clinic was a service developed in response to patient need and research by the outpatients department. The development of this work had led to additional support services available for patients with hand hygiene and contributed to staff development in outpatients.
• As part of the caring hands project, the trust had provided an additional two training sessions to home care managers and care staff in Newcastle. Information provided by the trust highlighted that they developing the education programme further.

However, there were also some areas of practice where the trust should make improvements.

The trust should:

• Ensure a consistent approach to displaying NHS safety thermometer data on wards at this hospital. This would assure patients that the hospital was improving practice, based on experience and information.
• Consider implementation of regular record audits within the outpatient department.
• Consider governance leads within the outpatients department.

Professor Sir Mike Richards

Chief Inspector of Hospitals