Babington Hospital is a community hospital in Belper, Derbyshire, providing services in Amber Valley in South Derbyshire and Derby, with some Nottinghamshire and North Derbyshire patients being admitted.

At the time of our visit there was one inpatient ward, Baron, which provides rehabilitation services for up to 20 adults. Chevin ward, which provides up to nine beds to help manage the additional demand during the winter months had recently closed. Baron ward held an additional four beds for people with complex conditions unable to be discharged. This arrangement was planned to continue until the end of March 2014.

Patients were very positive about the caring way staff treated them. They felt involved in their care plans and received information in a way they could understand it. We observed staff using good communication skills to establish rapport with patients and build their trust. Bathroom and toilet windows were not fully obscured at night so that patients’ dignity was compromised.

The Trust employed a range of specialist teams to support staff on inpatient units. These included continence nurse specialists, the falls team and speech and language therapists. There were plans for seven day working to cover all four local hospitals including Babington, to provide a better service for patients.

Patients on the ward received integrated rehabilitation from an effective multidisciplinary team. The staff had developed opportunities to promote people’s independence and emotional well-being. Patients’ progress was monitored and reviewed and the staff team could access other professionals for advice as needed. There were sufficient staff on duty during the day but night time cover was not always sufficient to meet people’s needs.

There were systems in place to monitor and report safety incidents including falls and pressures ulcers. There was a culture of learning as a result of incidents. Patients’ care was centred on safety and preventing avoidable harm. Patient information was kept securely and the environment and equipment were appropriately maintained. We saw there were some discrepancies in recording patients’ nutritional needs which might put people at risk.

The discharge planning system on the ward was effective. There was good engagement with other partners including social care. Managers were largely seen as supportive and there were monthly staff meetings at which staff were encouraged to raise concerns. Staff had confidence that ward managers prioritised safe, high quality, compassionate care and escalated issues and concerns in an appropriate way. Not all staff felt valued by the Trust. Healthcare support workers felt in some cases their additional training and skills were not acknowledged and that opportunities for progression were limited.