Kidderminster Hospital and Treatment Centre

Updated 18 February 2025

The Worcestershire Acute Hospitals NHS Trust serves the population of Worcestershire and neighbouring counties from three main sites, Worcestershire Royal Hospital in Worcester, Alexandra Hospital in Redditch and Kidderminster Hospital and Treatment Centre in Kidderminster. According to the Trust’s website, in 2024 up to the date of this assessment they provided care to 143,002 inpatients, 670479 outpatient appointments, 170939 patients attended Accident and Emergency and there were 4,710 births.

Updated 24 July 2024

Kidderminster Hospital and Treatment Centre (KHTC) provides outpatient services and day surgery for children and young people. The children’s outpatient department at the KHTC is open Monday to Thursday; there are no clinics on Fridays or at the weekend. Children also attend the adult outpatient departments for some specialties including ophthalmology, ear nose and throat (ENT), audiology, trauma and orthopaedics and dermatology. Data provided by the trust indicated between 1 September 2023 and 31 August 2024 there were a total of 8,229 outpatient attendances by children and young people under the age of 18 years at Kidderminster Hospital and Treatment Centre. Of these, 2306 attendances were in paediatric specialties and the remaining 5923 were children seen in other specialties. Day surgery for children and young people was provided on the 1st, 3rd and 5th Friday of each month. From 1 September 2023 to 31 August 2024 489 children and young people under the age of 18 years had day case surgery at KHTC. Over 97% of day surgery episodes for children and young people were in ENT, oral surgery, ophthalmology, trauma and orthopaedics and urology. The onsite assessment of the children and young people service at KHTC was undertaken on 20 September 2024. Two Care Quality Commission inspectors, a children’s specialist advisor and an expert by experience carried out an unannounced (the service did not know we were coming) assessment. During the assessment we spoke with 10 children and young people,12 parents and carers, nursing and medical staff and leaders of the service. We reviewed staffing, 12 patient records, arrangements for medicines and policies and procedures used within children and young people’s service. We also carried out offsite interviews with staff, managers and commissioners of children’s services. The Children and Young People’s service was previously rated as requires improvement in June 2018. This assessment rated the service as good.

Updated 20 September 2019

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

• The service provided mandatory training including safeguarding to all staff and made sure everyone completed it. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
• The service generally had suitable premises and equipment and looked after them well. The service controlled infection risk well. Staff kept themselves, equipment and the premises clean.
• The service followed best practice when prescribing, giving, recording and storing medicines.
• Staff assessed and responded to patient risk appropriately. Records were clear, up-to-date and easily available to all staff providing care. The service managed patient safety incidents well.
• The service had enough nursing staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• The service generally provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance. Most managers monitored the effectiveness of care and treatment and used the findings to improve them.
• Staff gave patients enough food and drink to meet their needs and improve their health. Staff assessed and monitored patients regularly to see if they were in pain.
• Evidence provided, and observations made showed that staff were competent for their roles, which was an improvement since our last inspection. 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. Consent was consistently undertaken in line with the trust consent procedure.
• Staff cared for patients with compassion at all times during the inspection. Staff were friendly, professional and caring, even when under pressure during busy periods. Feedback from parents and relatives confirmed staff treated them well and with kindness.
• The service planned and provided services in a way that met the needs of local people. The service took account of patients’ individual needs. The service had a person-centred care approach to meeting the needs of people with complex or additional needs.
• Most patients could access the service when they needed to.
• The service treated concerns and complaints seriously, investigated and responded to them in a timely manner, learned lessons from the results, and shared these with all staff at meetings and safety huddles.
• Managers at all levels had the right skills and abilities to run a service providing high-quality sustainable care. Clinical leaders were visible in the department.
• There was a documented vision and strategy for what staff working within services wanted to achieve, in line with trust’s quality improvement strategy.
• The service had a systematic approach to continually monitor the quality of its services. The service monitored activity and performance and used data to identify areas for improvement. The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
• Staff and managers across the service promoted a positive culture that supported and valued one and other. Staff felt respected and valued which was an improvement since our last inspection.

However,

• The changing room facilities in endoscopy were not appropriate as they contained the only staff toilet in the department.
• The service was working towards achieving Joint Advisory Group (JAG) accreditation.
• Staff knowledge of audit and performance related to audit within endoscopy was variable.
• Some patients had delays in accessing some endoscopy services.

Updated 20 September 2019

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

• The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
• The service controlled infection risk well.
• The service had suitable premises and equipment and looked after them well. All diagnostic and imaging equipment was tested and serviced regularly to ensure that it was safe to use.
• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary. Risk assessments were completed for all patients using the service, and there were processes in place to escalate any concerns.
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service made sure staff were competent for their roles.
• The service followed best practice when prescribing, giving, recording and storing medicines. Staff ensured that radiation doses were in line with national guidance.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
• Managers monitored the effectiveness of care and treatment and used the findings to improve them. Discrepancy meetings were held and that there was a process for discrepancy feedback outsourced work.
• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Staff respected patient’s privacy and dignity. The service took account of patients’ individual needs.
• Patients could access the service when they needed it. Waiting times to treat patients were generally in line with good practice. Most patients received diagnostic imaging within the six week target. The backlog of unreported images and delays in reporting had significantly improved.
• The service had managers at all levels with the right skills and abilities to run a service providing high-quality sustainable care. Clinical leaders were visible in the department. The team appeared focused and driven. Most staff reported leadership within the diagnostic and imaging departments was strong, with visible, supportive, and approachable managers and superintendents.

Updated 20 September 2019

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

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.
• 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 service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
• The service provided care and treatment based on national guidance and evidence-based practice.
• 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 development.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.
• The service had managers with the right skills and abilities to run a service providing high-quality sustainable care. Clinical leaders were visible in the department, but the trust board were not always known to staff.
• Staff and managers across the service promoted a positive culture that supported and valued one and other.

However:

• People could not always access the service when they needed it and did not always receive the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were not in line with national standards.
• The service had systems for identifying risks, planning to eliminate or reduce them. As these were often trust wide, it was hard to pinpoint risks to individual sites.

Updated 20 September 2019

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

• The service provided mandatory training in key skills to all staff and made sure most people had completed it.
• The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
• The service generally had suitable premises and equipment and looked after them well.
• The service had enough medical and nursing 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 patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance. Managers monitored the effectiveness of care and treatment and used the findings to improve them.
• Staff gave patients enough food and drink to meet their needs and improve their health. Staff assessed and monitored patients regularly to see if they were in pain.
• The service generally made sure staff were competent for their roles. Staff worked together as a team to benefit patients.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Staff involved patients and those close to them in decisions about their care and treatment.
• The service planned and provided services in a way that met the needs of local people
• The service took account of patients’ individual needs. The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
• Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care. The service had a vision for 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.
• Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The service used a systematic approach to continually improve and monitor the quality of its services. The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

However:

• Systems were mostly in place and effective in recognising and responding to deteriorating patients’ needs. Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary. However, staff did not always complete the brief and debrief within the five steps to surgery. We were therefore not assured that all staff were briefed prior to surgery and had the opportunity to debrief afterwards.
• The service followed best practice when prescribing, giving, recording and storing medicines. Patients generally received the right medication at the right dose at the right time. However, we found that four out of seven medication charts we looked at had missed doses. Therefore, we were not fully assured that all patients were given medicines when required.
• Not all staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff generally understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• People could not always access the service when they needed it. Waiting times from referral to treatment and arrangements to admit treat and discharge patients were not in line with good practice.

Updated 20 September 2019

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

• Staff did not complete risk assessments for all patients when they first arrived. Patients with potentially serious injuries sometimes had to wait for two hours before they received a clinical assessment.
• The service did not always provide care and treatment based on national guidance and evidence of its effectiveness. Much of the guidance provided for staff was out-of-date.
• Although managers at all levels had the right skills and abilities to run a service providing high-quality care, a cohesive, sustainable management strategy had not yet been achieved. This was, in part, due to the fragmented nature of the management structure and conflicting demands on the time of senior leaders.
• The MIU did not always have enough nursing staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• Although the MIU had systems for identifying risks and plans to eliminate or reduce them, we could not be certain there was a process for bringing them to the attention of senior leaders within the trust.

However,

• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• Managers monitored the effectiveness of care and treatment and used the findings to improve them. They made sure staff were competent for their roles by appraising work performance and holding supervision meetings with them to provide support.
• People could access the service when they needed it.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.
• The service had begun to use a systematic approach to continually improve the quality of its services and safeguarding high standards of care. There had been increased commitment to improving services by learning from when things went well and when they went wrong, as well as promoting training and practice improvement