ANEURIN BEVAN UNIVERSITY HEALTH BOARD
REPORT
SUBJECT:
CHC REPORT FOR ANEURIN BEVAN HEALTH
BOARD MEETING ON 25th May 2016
REPORT OF:
ANGELA MUTLOW
ACTING CHIEF OFFICER
CONTACT:
ANGELA MUTLOW
DATE:
10 MAY 2016
PURPOSE: To inform Aneurin Bevan University Health Board of recent issues
of interest and concern being addressed by the Community Health Council in
relation to the planning and delivery of health services in Gwent.
CHC Mental Health Inpatient Unit Visits
During November and December 2015 the CHC undertook visits to Mental
Health inpatient units to review the environment, staff support, and patient
satisfaction with the care received. Common themes that emerged from many
of the visits were:
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Immaculate facilities and environment
Excellent support offered at mealtimes
Suitable dementia friendly environments on relevant wards
High patient satisfaction with care and support offered
Some staffing gaps e.g. nursing vacancies
Unlocked clinical waste bins.
Fundamentals of Care – Acute Hospitals
The CHC has recently completed the annual Fundamentals of Care visits to
ABuHB’s Acute Hospitals to assess the standard of nursing care afforded to
patients. The surveys were carried out unannounced in February 2016 on 8
wards across the two Acute Hospitals in Gwent. The review consisted of CHC
members’ observations and a patient survey.
Responses to the survey indicate an excellent level of nursing care in most
areas, 1 ward surveyed showed 95% compliance in all aspects of the survey in
the Royal Gwent Hospital (D2 West). Good practice was highlighted throughout
the visits such as; high levels of patient comfort, good access to fresh clean
water and excellent support during mealtimes. Some issues highlighted include;
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Variable access to communication aids
Some commodes not appropriately labelled with “I am clean” signs
Unlocked clinical waste bins
Some patients commenting that staffing levels should be higher due to
nurses/healthcare workers high level of busyness.
Linen Audits
The CHC undertook the annual linen audits of all wards throughout the ABuHB
in March 2016. In the majority of areas, staff reported that linen supplies had
improved drastically since the CHC began scrutinising this service
approximately 3 years ago. However, common themes remain despite further
available linen resources. Many wards still reported that weekend and bank
holiday supplies were short due to not receiving their full allocation of linen.
Another ward in Nevill Hall Hospital reported that a few weeks prior to the CHC
visit, some patients required drying with pillow cases due to a lack of towels.
The CHC is aware of the linen escalation processes in place for wards and
departments to request additional supplies in out of hours periods and queried
staff awareness and education around this process. Good Practice was
identified in Ysbyty Ystrad Fawr whereby linen supplies are stored centrally in a
heated portacabin and the management of requests for supplies all go through
a department supervisor. The supervisor however raised many of the same
issues found on other wards regarding weekend provisions.
A&E Day and Night Visits (joint visits with ABUHB Independent Member)
The CHC visited the Accident and Emergency departments in the Royal Gwent
Hospital and Nevill Hall Hospital in April 2016. Four visits took place; two day
time visits and two evening visits.
Royal Gwent Hospital day visit Monday 4th April – This was a morning visit to
the department, staff reported that bed availability on the wards was impacting
on waiting times in the department, as high levels of patients were presenting
with ‘complex needs’, which required admission to hospital. The medical and
nursing teams were prompt and informative with the 53 patients present on
members’ arrival and 59 patients present on the members’ departure. Members
noted that the numbers of ambulances arriving at the hospital increased
significantly during the morning adding to the demands placed on the
department.
Royal Gwent Hospital evening visit Friday 8th April (ABUHB Independent
Member in attendance) – At the time of the visit, ward bed availability was not
reported to be impacting on A&E waiting times and there was a full complement
of staff on duty, there were 27 majors and 3 minors patients. No patients were
waiting on trolleys located in the corridor. Patients stated that communication
from staff was good regarding waiting times. Ambulances arriving at the
department were at low levels during the visit. However, staff reported that this
was an improved position, as the department had experienced high levels of
demand and significant pressures in the preceding week, which had impacted
more generally on services within the hospital..
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Nevill Hall Hospital day visit Monday 4th April (ABUHB Independent Member in
attendance) – At the time of the visit, staff reported that reduced bed availability
within the hospital was having an impact on waiting times in A&E, as high
numbers of patients required admission. It was suggested by staff that the
availability of occupational therapists at weekends might facilitate further
discharges to help with the position. It was also suggested that additional
support staff and volunteers within the department might assist with ensuring
that patients waiting in the department were supported with easier access to
refreshments. At the time of the visit, there were 30 patients present, with 8
patients waiting in the corridor. It was considered by members that the
department at that time was very crowded and therefore not the most ideal
environment. However, communication with patients was not an issue.
Nevill Hall Hospital evening visit Friday 8th April – At the time of the visit ward
bed availability was not impacting on the waiting times in A&E and there were
28 patients in the unit during the members’ visit, a full complement of staff was
on duty. No issues were highlighted regarding the ambulance handover times.
Due to the busyness of the department, however, members considered that
there was potentially a lack of privacy for patients. All cubicles were full,
therefore the options for patients requiring isolation might have been an issue.
There were also patients being cared for in the corridor at that time and the
resus room was unavailable as it was already in use. However, the medical and
nursing teams were observed as helpful and attentive towards patients as well
as keeping them informed. Patients spoken to were all happy with the
communication from staff.
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