We had not previously rated this hospital. We rated it them as good because:

• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
• Staff kept themselves, equipment and the premises clean.
• We saw evidence that staff prescribed, administered, recorded and stored medicines appropriately.
• There were some outstanding example of staff caring for patients and their families, particularly in the critical care units and for patients receiving end of life care.
• The services took account of most patients’ individual needs. For example, there were systems in place to support vulnerable patients within surgical services, including a ‘theatre buddy’ system, cognitive impairment trollies, communication aids and activity boxes.
• The service planned and provided services in a way that met the needs of local people. People could mostly access the service when they needed it.
• Managers across the services had the right skills and abilities to run a service providing high-quality sustainable care.
• There was a positive culture across the hospital and most staff were positive about the leadership changes.

However:

• Planned staffing levels were not consistently achieved particularly in the emergency department.
• The hospital consistently failed to meet the standards for waiting times from referral to treatment and arrangements to admit, treat and discharge patients within four hours and the trust’s monthly median total time in the department for all patients was consistently longer than the England average.
• The service did not always have sufficiently robust procedures in place to meet the needs of patients with additional support needs. We saw examples of where staff were not responsive to ensuring the patients’ needs were documented and followed.
• Although, the service treated concerns and complaints seriously as well as investigating them, the response time to complaints was not timely and did not meet the trust’s policy.
• Capacity assessments and Deprivation of Liberty Safeguard applications were not always fully completed particularly in medical wards and the emergency department.