Peterborough City Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Patients received care, treatment and support that was evidence-based and in line with good practice standards. Systems in place ensured staff were up to date with national legislation, and evidence-based good practice. Staff and leaders were encouraged to learn about new and innovative approaches to improve the way care was delivered.

However, patients' nutrition and hydration needs were not always met. Three patients we spoke with told us they did not have access to meals that were specific to their dietary requirements, or that they did not receive the meal they had requested.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff did not always meet people’s nutrition and hydration needs. Most patients we spoke with on assessment told us that they had access to meals and drinks when required, and that their nutrition and hydration needs were met. However, some patients we spoke with, particularly those cared for in the corridor, told us that they did not have access to meals that were specific to their dietary requirements, and another told us they did not receive a meal as it had not been requested by the ward. We spoke with one boarding patient who was not aware and had not been informed that their lunch had been placed on a table. He told us he required assistance to open the sandwich, but support for this was not offered. An inpatient on the stroke ward told us that staff were not always available to support in cutting up food at meal times.

Staff gave people information about their care and treatment needed to support both their physical and mental health. A patient told us they were given verbal and written information on how to manage their diabetes and weight in order to reduce further complications in health.

Staff told us that mealtimes were protected and that they supported patients with meals as required. However, staff felt that, at times, low staffing impacted on their ability to assist multiple patients with meals. We spoke with a catering hostess who told us that they would ring a patient’s call bell if they required support with meals and if meals had not been eaten, they would not be cleared so that staff were aware.



Staff told us that meals for patients cared for in corridors would need to be requested directly and this was not recorded in line with the bedded patient’s on the ward. This, at times, led to meals not being requested in time and patients having to wait for 1-2 hours for a hot meal. Staff did report that patients were able to request a snack box at any time which offered a sandwich, drink and fruit. However, it was acknowledged that this was not always suitable for patients on a modified diet.

Staff used effective tools for screening malnutrition and dehydration and acted on any indicators of concern. Staff told us that they completed the Malnutrition Universal Screening Tool (MUST) as part of the adult admission nursing assessment. Staff were able to discuss how and when they would complete a dietician referral.

Staff told us that they received training that was specific to the speciality of the ward aligned with good practice to deliver effective care. A nurse told us that the specialist nurses supported staff and patients during their admission ensuring care was in line with best practice.

Staff followed up-to-date policies to plan and deliver high quality care according to evidence-based practice and national guidance. We reviewed a variety policies and guidelines and noted all were up to date. Staff used evidence-based, standardised risk assessment tools to identify the level of patient risk for areas such as pressure ulcers and nutrition level. Staff in medical care worked with staff from other areas of to improve outcomes for patients by reducing the endoscopy waiting list, increasing the number of patients discharged each day, and the introduction of virtual clinics for patients receiving treatment for irritable bowel disease.

There was a process in place to ensure that all adults had MUST action and prevention plans following admission.

Staff encouraged patients to drink and for one patient, we saw a staff member spending additional time to support them to drink orally to reduce their need for fluids through a PEG. Patients with difficulty eating were identified through a Red Tray system. However, boarding patients cared for in corridors had to have their food ordered directly with the kitchen. We did see instances where boarded patients either did not receive meals or received incorrect meals for their dietary needs.

Leaders encouraged innovation and participation in research. Staff in the service collaborated with regional trusts and technology providers to support the introduction of new practice. We received information about several examples of initiatives, innovations and quality improvement carried out in the service. This included participation in the use of a sub-epidermal moisture (SEM) scanner for early detection of tissue injury, which allowed staff to reconsider how they cared for the patient to reduce the risk of skin breakdown. The service was in the process of introducing digital technology to enable patients to see their own records, monitor conditions such as atrial fibrillation or improve fast detection of strokes.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.