Source · CQC inspection

Royal National Hospital for Rheumatic Diseases

Provider Royal United Hospitals Bath NHS Foundation Trust Type NHS Healthcare Organisation Region South West Last inspected 27 Jun 2018

Overall rating: Requires Improvement  View full CQC report

Domain ratings

Five CQC key questions
Safe
Requires Improvement
Effective
Good
Caring
Good
Responsive
Requires Improvement
Well-led
Requires Improvement

Earlier inspection findings

pre-2024 framework · 2 must-do 16 should-do

Must-do actions (2)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 2
Must do
Safe
The trust must ensure care records and documentation such as risk assessments, referrals to other professionals and clinicians, care plans and monitoring records such as food and fluid charts are in place. The records should be in sufficient detail and maintained appropriately to direct and inform staff on the action they must take to meet the care and treatment needs for patients.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Patients admitted to the medical ward with complex needs did not have care plans in place to provide staff with detailed information and guidance regarding their care and treatment needs. Patient monitoring records and charts were not fully or consistently completed. It was not clear that correct procedures had been …
Must-do action 2 of 2
Must do
Safe
The trust must ensure that appropriate medical care is provided for patients transferred to the Royal National Hospital for Rheumatic Diseases from the medical wards at Royal United Hospital.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ There was not a clear system in place to provide consultant cover for medical patients transferred from RUH. Not all services were operational over seven days, lacking routine access to therapy, x-ray, and medical staff out of hours. Medical patients transferred from RUH often did not meet admission criteria, had …

Should-do actions (16)

Recommended improvements to enhance service quality.

Should-do action 1 of 16
Should do
Safe
The trust should ensure that staff have access to up to date information on the patient’s infection status in particular in relation to MRSA.
Should-do action 2 of 16
Should do
Safe
The trust should ensure robust procedures are put in place for ensuring the promotion and control of infection regarding the routine steam cleaning of the ward and equipment.
Should-do action 3 of 16
Should do
Well-led
The trust should encourage all staff to complete incident reports themselves.
Should-do action 4 of 16
Should do
Well-led
Staff should have access to feedback following the reporting of incidents to ensure that learning takes place after an incident.
Should-do action 5 of 16
Should do
Safe
The trust should ensure that records demonstrate the action taken when safeguarding concerns are identified.
Should-do action 6 of 16
Should do
Responsive
The trust should ensure that patients and visitors to the hospital can easily find their way to all departments.
Should-do action 7 of 16
Should do
Safe
The trust should ensure that patients can access handwashing facilities in every toilet.
Should-do action 8 of 16
Should do
Safe
The trust should ensure that fluids for intravenous infusion are not accessible to patients and visitors to the ward.
Should-do action 9 of 16
Should do
Safe
The trust should ensure that the mandatory training is kept up to date for all staff.
Should-do action 10 of 16
Should do
Safe
All equipment should be serviced, maintained and/or calibrated to ensure it was fit for purpose and ready to use.
Should-do action 11 of 16
Should do
Safe
The trust should ensure all staff were confident and competent to use emergency equipment when necessary.
Should-do action 12 of 16
Should do
Safe
All staff should be trained and competent to use emergency evacuation equipment.
Should-do action 13 of 16
Should do
Responsive
The trust should ensure that patient’s medical care and treatment needs can be met at the RNHRD before transfers are arranged. The transfer criteria should be complied with.
Should-do action 14 of 16
Should do
Effective
The trust should look to reference the guidance by The Law Society in its policy relating to Deprivation of Liberty, and ensure there is flexibility within the policy when applying the 72-hour rule.
Should-do action 15 of 16
Should do
Well-led
The trust should ensure governance systems continue to be embedded.
Should-do action 16 of 16
Should do
Well-led
The trust should ensure monitoring and quality measurement of the care and treatment records is in operation.

Location details

CQC ID: RD115
Local authority: Bath and North East Somerset
Region: South West

Inspection report

Type: Comprehensive inspection
Date: 27 June 2018
Rating: Requires improvement
Actions: 2 must-do 16 should-do
AI-extracted 3 Jun 2026