George Eliot NHS Hospital

Updated 23 December 2024

George Eliot Hospital NHS Trust was opened in 1984 and provides a range of hospital and community-based services to more than 300,000 people across Nuneaton and Bedworth, North Warwickshire, Southwest Leicestershire and North Coventry. The hospital offers services at all these locations: George Eliot Hospital Pine Clinic Stratford Healthcare. The main hospital site is George Eliot Hospital which is in Nuneaton. George Eliot Hospital provides services including urgent and emergency care, medical care and surgery. During this assessment, we visited outpatient services and critical care services, Diagnostic Imaging service and Medical Care service. There are approximately 358 beds including 8 critical care beds, 12-day care beds and a coronary care unit with 11 beds. There are 14 inpatient wards and 8 operating theatres providing planned and emergency surgical care. Specialities include trauma and orthopaedics, general surgery, urology and gynaecology. There are no inpatient facilities for children and young people, however day case procedures are completed for children between the ages of 2 and 16 years old.

Updated 26 February 2024

Critical care provides care for level 2 patients (those considered as requiring high dependency care) and level 3 patients (those who require intensive therapy). The service also provides a critical care outreach team (CCOT) who supports patients that may be deteriorating whilst admitted within the ward areas. The CCOT provide a service 24 hours a day, 7 days a week. The service also has 24 hour presence of consultants and registrars. During our assessment, we spoke with 27 members of staff of all roles and responsibilities, spoke with 1 patient and reviewed 4 patient records. During this assessment we found the service remained good in all 5 key questions. Safety was a priority for everyone and leaders embedded a culture of openness. Patients were safe and protected from abuse, avoidable harm and infection. Leaders ensured there were enough, skilled staff to provide care and treatment for patients in safe environments. Patients had their best possible outcomes. Their needs were assessed and their treatment reflected their needs. Staff worked in harmony and patients were at the centre of their care. Patients were treated with kindness, empathy and compassion. Staff respected patients privacy and dignity and took into account patients wishes and choices. Patients and the communities the service served was at the centre of how care was planned and delivered. Patients had access to the care and treatment they required and accessed it in ways which met their personal circumstances. There was an inclusive and positive culture which was also focused on continuous learning and improvement. Leaders were proactive and approachable and there was clear responsibilities, roles and systems of accountability and good governance. However: Compliance was low for key training requirements including life support and safeguarding level 3. We found staff did not always adhere to correct process when completing the Recommended Summary Plan for Emergency Care and Treatment plans.

Updated 16 April 2024

Date of assessment 14 May to 15 June 2024 The types of diagnostic imaging offered by the department included general X-ray, fluoroscopy and interventional radiology, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound imaging, and dual energy X-ray absorptiometry (DXA) scans. For the purposes of this report, the different types of imaging will be referred to as modalities. There were 2 radiology departments on the hospital site, the new Community Diagnostic Centre that sat within the clinical services directorate and the main radiology department that came under the urgent and emergency care directorate. When we refer to the department in the report we mean both the community diagnostic centre and the main radiology department. In the 12 months before the inspection, the service had performed a total of 153,703 examinations across all modalities. This included 28507 CT scans, 16536 MRI scans, 78496 x-rays, 28859 ultrasound scans and 1305 DEXA scans. The inspection team comprised of a CQC inspector and a specialist advisor with expertise in diagnostic imaging. On the second day the team were joined by 2 Pharmacist Specialists and a regulatory co-ordinator. We spoke with 34 members of staff, 15 patients and 2 relatives and observed interactions with patients on both days.

Updated 16 April 2024

The medical care services at the trust provide care and treatment for different specialities. During our assessment we visited the frailty ward (Bob Jakin), Stroke ward (Felix Holt), gastroenterology wards (Mary Garth ward and Adam Bede ward), Cardiac care unit, medical assessment unit (AMU), diabetic ward (Melly ward), respiratory ward (Elizabeth ward), and general medical wards including Alexandra ward, Victoria ward and Arbury Lodge. As part of our assessment, we looked at 32 patient records, spoke with 26 patients, 3 relatives and 81 members of staff including ward managers, a matron, doctors, nurses, healthcare assistants and students. This assessment was completed due to aged ratings and therefore we were able to re-rate the service. Medical care has been re-rated as good overall. The previous rating of requires improvement for safe, effective, and well-led improved to good. Caring remained good and Responsive remained as requires improvement. We found: There was evidence of a learning culture and patients were cared for in a safe environment. There were processes in place to assess the needs of the patients using evidence-based tools. Staff provided patients with patient-centred care and treatment. There were governance processes in place which were effective and staff knew their roles and responsibilities.

Updated 26 February 2024

Outpatient services provided clinics covering a range of specialities which included but was not limited trauma and orthopaedics, urology, general surgery and respiratory conditions. During our assessment we spoke with 28 members of staff of al roles and responsibilities, 24 patients and reviewed 5 patient records. We also observed 8 clinic appointments with patient consent. We rated the service as good in all 5 key questions. This was the first time we had the powers to rate effective in this service. Safety was a priority for everyone, and leaders embedded a culture of openness. Patients were safe and protected from abuse, avoidable harm and infection. Leaders ensured there were enough, skilled staff to provide care and treatment for patients in safe environments. Patients had their best possible outcomes. Their needs were assessed, and their treatment reflected their needs. Staff worked in harmony and patients were at the centre of their care. Patients were treated with kindness, empathy and compassion. Staff respected patients' privacy and dignity and took into account patient's wishes and choices. Patients and the communities the service served was at the centre of how care was planned and delivered. Patients had access to the care and treatment they required and accessed it in ways which met their personal circumstances. There was an inclusive and positive culture which was also focused on continuous learning and improvement. Leaders were proactive and approachable and there was clear responsibilities, roles and systems of accountability and good governance.

Updated 26 February 2019

• The service provided mandatory training in key skills to all staff and nursing staff were mainly compliant.
• Staff understood how to protect patients from abuse and the service worked well with other agencies. The trust target of 85% compliance was met for the majority of safeguarding training courses.
• The service controlled infection risk well.
• The service had suitable premises and equipment and looked after them well. Equipment was checked at regular intervals to ensure it was safe for use.
• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.
• The service had sufficient nursing staff with the right qualifications, skills, training and experience. Staffing levels were safe at the time of the inspection and we saw evidence of this in all the areas we visited.
• At the time of the inspection there were sufficient medical staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• Staff kept detailed records of patient’s care and treatment and individual records were managed in a way that mainly kept patient’s safe. Records were stored securely in all the areas we visited.
• Staff prescribed gave and recorded medicines well. Patients received the right medication and the right dose at the right time.
• Staff recognised incidents and reported them appropriately. Managers investigated incidents and provided feedback to staff. 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 gave patients enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary.
• Pain was assessed and managed well.
• The service monitored the effectiveness of care and treatment and used the findings to improve them. They compared local results with those of other services to learn from them. Outcomes were generally better than the national average. Action plans were in place to address any shortcomings.
• The service made sure staff were competent in their roles.
• Staff worked together as a team to benefit patients.
• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. They followed trust policy and procedures when a child or young person could not give consent. The majority of staff in children’s services had undertaken training in the Mental Capacity Act (MCA).
• Staff cared for babies, children and young people with compassion. Feedback from children and parents confirmed that staff treated them well and with kindness.
• Staff provided emotional support to patients to minimise their distress.
• Staff involved patients and those close to them in decisions about their treatment. Parents were encouraged to be actively involved in their children’s care.
• The trust planned and delivered services to meet the needs of local people.
• The service took account of children and young people’s needs.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results and shared these with staff.
• Senior managers in children’s services had the right skills and abilities to address risks identified in sustaining paediatrics at the hospital. Performance issues across clinical teams in children’s and urgent care services continued to be addressed and we saw improvements in the local leadership and management of children’s services starting to emerge.
• The service had a vision of what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients and key groups representing the local community.
• Senior managers were continuing to promote a positive culture to help address the challenges raised at the previous inspection. Improvements in behaviours and staff morale were observed and a sense of common purpose across CAU and ED was starting to emerge.
• The service used a systematic approach to continually improve the quality of its services and safeguarding high standards of care by creating an environment in which excellent care would flourish.
• The service had effective systems for identifying risks, planning to eliminate or reduce them, coping with both the expected and unexpected.
• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.
• The service engaged with patient’s, staff and the public to plan and manage appropriate services for children, young people and their families.
• The service was committed to improving services by learning from when things went well and when things went wrong in promoting training, research and innovation.

However

• There were four patients who had been referred to the child and adolescent mental health service (CAMHS) that were in the CAU for over 12 hours awaiting admission to the nearby NHS acute trust for assessment. This then affected the flow of other patients through CAU. We raised this with the service at the time of the inspection who were taking the appropriate actions to address current concerns and a multi-agency action plan was in place with Coventry and Warwickshire.
• Children’s services had identified paediatrics as a risk to the organisation due to the inability to recruit a substantive medical workforce and financial sustainability. However, the trust was taking the appropriate actions to address the service shortfalls.
• Although the service prior to the inspection had not identified the risks associated with CYP waiting for an acute paediatric bed for mental health assessment, additional data demonstrated the service was working closely with Coventry and Warwickshire on a multi-agency action plan which included reviewing the risks posed to CYP.
• Medical staff were not meeting the 85% trust standard for mandatory training.

Updated 26 February 2019

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

• The last inspection in 2017 identified the trust did not always ensure there were sufficient quantities of equipment to maintain the safety of patients. This had improved during this inspection. No incidents concerning delays in patient care due to the lack of availability of syringe drivers had been reported in a 12-month period.
• The service now had sufficient numbers of suitably qualified, competent, skilled and experienced persons in end of life care services. There was palliative care consultant in post within the specialist palliative care team (SPCT) at the time of our inspection.
• The trust did not consistently assess, monitor and improve the quality and safety of the services it provided during our last inspection. This had improved during this inspection. The service now completed audits to identify if evidence-based, end of life documentation was consistently completed and reviewed. For example, staff had carried out an audit on preferred place of death for patients known to SPCT and used the audit to evaluate the quality of the information collated in the care plans.
• The trust had appointed end of life care champions in various ward areas and ensured the delivery of end of life care training was sufficient throughout the hospital.
• Staff were caring and compassionate and end of life care services provided a flexible service to meet the needs of local people.

Updated 15 November 2023

Updated 19 May 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, advised them on how to lead healthier lives, 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 could not always access the service when they needed it and had to wait too long for treatment.

However,

• 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 7 July 2023