Mixed findings as Wales’ health boards go under the microscope CARDIFF & VALE UNIVERSITY HEALTH BOARD
Inspectors visit Wales’ seven health boards every year. They conduct unannounced inspections at hospitals, GP practices and dentists’ and judge whether standards are being met. Here Mark Smith looks at the latest Healthcare Inspectorate Wales’ (HIW) repor
Hospitals The University Hospital of Wales’ emergency unit was inspected in March 2017.
Inspectors found that the department offered a good standard of care and treatment to patients.
They said staff demonstrated “enthusiasm and compassion” in providing safe and dignified care.
Senior employees were also praised for supporting junior medics in a timely manner, and clinical environments were described as clean and tidy.
But there were concerns about the condition of the paediatric unit in A&E. The environment leading to wards was also criticised as having the potential to “pose a health and safety risk” to patients and staff.
There was also scope for improvements in infection control practices and principles. General Practice Inspectors found that services were “operating very well” despite the challenges in providing timely appointments. They said there was evidence of good management and leadership, with two practices in particular developing “very good systems” of audit and governance. Dental Practice Ten inspections were carried out in 2016-17. While patients were happy with the service being provided, inspectors said record-keeping needed improving at all sites they visited. Decontamination and sterilisation issues were noted in nine inspections, and four of the practices were in a “poor” or “unsatisfactory” state of repair. through the emergency unit.
It also found that security needed to be reviewed.
Ward 10, which covers trauma and orthopaedics, was inspected following concerns at the previous inspection. Inspectors said “limited progress” had been made in applying improvement actions.
They also said there needed to be improvement around promoting patients’ privacy and dignity, and timeliness of responding to patients’ requests for assistance. General Practice Nine inspections were carried out in total throughout 2016-17.
The findings were described as very positive, with evidence of good management and leadership, and a good standard of record-keeping by GPs and nurses in all practices.
They also found examples of innovative work to improve patient uptake of vaccinations in one practice, and in record-keeping at another practice.
But two of the practices needed to review their concerns and complaints procedures. Dental Practice Inspectors found the majority of practices to be “well equipped, clean and tidy”.
But of the nine inspections, three were identified as having patient safety concerns.
There were issues with availability and checks of emergency equipment in the event of a patient collapse.
Improvements were needed to risk assessments, policies or procedures in seven of the 10 inspections, and record-keeping was an issue in five practices. was needed around the recording of patients’ pain and monitoring of treatment.
Patients were observed on trolleys in corridors, which presented challenges around their dignity and privacy. Improvements were also needed when recording the timeliness of risk assessments for patients’ wellbeing and safety, particularly for pressure and tissue damage, and falls.
Documentation also needs to be improved for monitoring the temperatures of fridges used to store medication.
Unlike other reports, HIW did not specify which hospitals or wards they visited. General Practice There were three GP inspections in the Cwm Taf area in 2016-17.
Staff appeared to be happy and supported by good leadership. However, there were recommendations requiring practices to comply with the Welsh Language Standards for Healthcare, and to ensure employment and recruitment processes are improved. Dental Four dental practices inspected in 2016-17.
Inspections of these practices were largely positive, with one practice having no areas of non-compliance. But there were issues over reviewing and maintaining policies and procedures, record-keeping and checking maintenance of equipment. were
Inspectors said they observed “strong medical and nursing leadership” within the department with good communication and professional relationships.
But a number of problems were identified in the administration of controlled drugs and delays in prescribing, while there were examples of patients at risk of developing pressure areas. General Practice Inspectors said they consistently found patient records to be of a good standard, and “clear arrangements” were in place at most practices to promote safe and effective patient care. But they warned that better facilities needed to be put in place at some reception areas for patients to have private or confidential discussions.
Dental Practice from patients. But some needed greater clarity on how patients can make complaints.