Source · CQC inspection
Royal Sussex County Hospital
Provider Brighton and Sussex University Hospitals NHS Trust
Type NHS Healthcare Organisation
Region South East
Last inspected 25 Feb 2021
Overall rating: Good View full CQC report
Domain ratings
Safe
Good
Effective
Good
Caring
Outstanding
Responsive
Requires Improvement
Well-led
Good
Earlier inspection findings
Must-do actions (2)
Must-do action 1 of 2
Must do
Safe
The trust must ensure that senior staff are monitoring any delays in the initial clinical assessment of self-presenting patients so that all patients are assessed in a timely manner. This particularly applies to children and to all patients arriving during the night.
Must-do action 2 of 2
Must do
Safe
The trust must monitor nurse staffing levels using an acuity-based staffing tool to ensure there are always enough nurses in the emergency department.
Should-do actions (64)
Should-do action 1 of 64
Should do
Effective
The trust should consider reviewing the length of nursing documentation.
Should-do action 2 of 64
Should do
Safe
The trust should ensure that there is an effective process to check the expiry date of medicines.
Should-do action 3 of 64
Should do
Safe
The trust should improve extended advanced life and trauma training for nurses.
Should-do action 4 of 64
Should do
Safe
The trust should ensure that patients identified at an increased risk of developing a pressure ulcer are given preventative equipment promptly.
Should-do action 5 of 64
Should do
Safe
The trust should ensure mandatory training including Safeguarding adult training is improved amongst medical staff.
Should-do action 6 of 64
Should do
Caring
The trust should ensure patients are aware of their right to have a chaperone.
Should-do action 7 of 64
Should do
Safe
The trust should ensure intravenous fluids are prescribed in line with trust policy.
Should-do action 8 of 64
Should do
Safe
The trust should consider the risk to patients who self-present to the hospital and the length of time until they receive an assessment.
Should-do action 9 of 64
Should do
Responsive
The trust should continue to improve efficiency and flow to improve performance and meet standards.
Should-do action 10 of 64
Should do
Well-led
The trust should consider how they align with the trust’s strategy.
Should-do action 11 of 64
Should do
Responsive
The trust should should ensure that ambulance crews can handover their patients as soon as possible so that they can be released to respond to further emergency calls.
Should-do action 12 of 64
Should do
Safe
The trust should ensure that all patients who require an early warning score have this calculated as part of their triage assessment and at the required frequency during their treatment.
Should-do action 13 of 64
Should do
Responsive
The trust should work with the neighbouring mental health trust to reduce the delays in admitting patients to specialist mental health units.
Should-do action 14 of 64
Should do
Safe
The trust should ensure that patient safety checklists are completed hourly.
Should-do action 15 of 64
Should do
Safe
The trust should maintain records of the number of doctors who have completed advance resuscitation training.
Should-do action 16 of 64
Should do
Responsive
The trust should improve their referral to treatment performance.
Should-do action 17 of 64
Should do
Safe
The trust should ensure there are policies and procedures for patients to self-administer medicines if appropriate
Should-do action 18 of 64
Should do
Well-led
The trust should ensure that when developing or extending services, the pharmacy service is involved in planning and appropriate resources are provided
Should-do action 19 of 64
Should do
Responsive
The trust should ensure seven-day services were made available for the dietetic and speech and language therapy services.
Should-do action 20 of 64
Should do
Safe
The trust should ensure the layout of all medication paperwork be clear for prescribers where they are required to record the date of each prescription to eliminate any potential confusion.
Should-do action 21 of 64
Should do
Safe
The trust should ensure printed copies of NEWS2 and sepsis assessment sections showed consistent trigger scores for escalation to avoid any confusion for staff.
Should-do action 22 of 64
Should do
Well-led
The trust should continue their efforts to address the nursing and medical workforce challenges.
Should-do action 23 of 64
Should do
Well-led
The trust should ensure the vacancy for the clinical lead for specialty medicine in this division is filled.
Should-do action 24 of 64
Should do
Effective
The trust should continue to carry out the actions they identified from the national audits such as the Lung Cancer Audit 2017 and National Audit of Inpatient Falls 2017.
Should-do action 25 of 64
Should do
Caring
The trust should ensure staff followed trust standards to ensure name boards were completed.
Should-do action 26 of 64
Should do
Safe
The trust should complete all actions found in the fire risk assessments on wards Level 8a East and Level 8a West.
Should-do action 27 of 64
Should do
Safe
The trust should ensure all equipment in use is serviced in line with services schedule.
Should-do action 28 of 64
Should do
Safe
The trust should ensure staff record why medications are not administered.
Should-do action 29 of 64
Should do
Responsive
The trust should ensure that patients were not staying longer than their required recovery time in theatres.
Should-do action 30 of 64
Should do
Responsive
The trust should continue to work on reducing its referral to treatment times across all specialties.
Should-do action 31 of 64
Should do
Well-led
The trust should engage with patients in such a way as to develop their services.
Should-do action 32 of 64
Should do
Safe
The trust should ensure the walls and fixtures and fittings meet the Department of Health’s Health Building Note 00-09.
Should-do action 33 of 64
Should do
Effective
The trust should ensure that consent to care and treatment is always sought in line with legislation, best practice and guidance.
Should-do action 34 of 64
Should do
Responsive
The trust should improve the signage for patients and visitors to navigate their way around the hospital.
Should-do action 35 of 64
Should do
Safe
The trust should ensure that Local Safety Standards for Invasive Procedures (LocSIPPs) using the National Safety Standards for Invasive Procedures (NatSSIPs), are in place and staff are aware of their availability.
Should-do action 36 of 64
Should do
Safe
The trust should make sure all locum doctors receive a local induction, to the hospital and ward they are working on.
Should-do action 37 of 64
Should do
Safe
The trust should The trust should implement an effective system to ensure patients were not fasted for longer periods than clinically necessary.
Should-do action 38 of 64
Should do
Responsive
The trust should continue to work with the rest of the hospital to reduce the length of time from a patient being identified as ward ready in the critical care unit to being discharged.
Should-do action 39 of 64
Should do
Effective
The trust should review how it screens patients for dementia in the critical care environment.
Should-do action 40 of 64
Should do
Caring
The trust should develop a system that ensures that patient diaries stay with the patient when they leave critical care.
Should-do action 41 of 64
Should do
Caring
The trust should review the provision of psychological support provided to patients during their stay in critical care.
Should-do action 42 of 64
Should do
Effective
The trust should look to provide training for all staff to better equip them when dealing with patients with mental ill health.
Should-do action 43 of 64
Should do
Well-led
The trust should continue the work that had already started to integrate the cardiac critical care unit with the general and neuro critical care units.
Should-do action 44 of 64
Should do
Effective
The trust should continue the upward trend of completing pain assessments for all patients.
Should-do action 45 of 64
Should do
Responsive
The trust should continue to work to further reduce the number of out of hours discharges.
Should-do action 46 of 64
Should do
Safe
The trust should develop stronger oversight of cleaning schedules and completion of cleaning rotas for staff and housekeeping.
Should-do action 47 of 64
Should do
Well-led
The trust should strengthen and create more robust audit processes to obtain more reliable, valid and accurate data, particularly regarding hand hygiene and environmental cleanliness standards.
Should-do action 48 of 64
Should do
Effective
The trust should should have a centralised record of each staff’s competencies and training.
Should-do action 49 of 64
Should do
Effective
The trust should complete pain assessments for all patients even if they score 0.
Should-do action 50 of 64
Should do
Responsive
The trust should improve signposting throughout the hospital.
Should-do action 51 of 64
Should do
Effective
The trust should continue to develop plans and policies to strengthen the provision of mental health services to patients in the critical care unit.
Should-do action 52 of 64
Should do
Safe
The trust should ensure hand hygiene audits are consistently completed.
Should-do action 53 of 64
Should do
Safe
The trust should ensure all staff adhere to bare below the elbows.
Should-do action 54 of 64
Should do
Safe
The trust should ensure daily equipment checklists are completed.
Should-do action 55 of 64
Should do
Safe
The trust should ensure room and fridge temperatures are recorded accurately and action taken when the readings are outside of expected range.
Should-do action 56 of 64
Should do
Safe
The trust should have processes in place to review the quality and accuracy of patient records.
Should-do action 57 of 64
Should do
Safe
The trust should ensure patient confidentiality is always protected.
Should-do action 58 of 64
Should do
Safe
The trust should ensure that patient records are audited for quality.
Should-do action 59 of 64
Should do
Well-led
The trust should continue to develop the leadership and governance functions of outpatients. Staff should be appropriately involved in all areas of performance. Performance monitoring activities undertaken by staff should be meaningful and focused on improving performance.
Should-do action 60 of 64
Should do
Responsive
The trust should ensure that outpatients services are included as part of the dementia strategy.
Should-do action 61 of 64
Should do
Effective
The trust should ensure that staff in outpatients receive training in the mental health act.
Should-do action 62 of 64
Should do
Well-led
The trust should ensure that action plans are implemented and monitored following poor performance in three areas of the Patient Led Assessments of the Care Environment scores.
Should-do action 63 of 64
Should do
Safe
The trust should ensure that only registered nurses carry medicines keys.
Should-do action 64 of 64
Should do
Safe
The trust should ensure that the waiting area and environment in phlebotomy is safe for staff and patients using it.