During this inspection we visited Caterham Dene Ward, the Minor Injuries Unit and spoke with staff from the Rapid Assessment Clinic.

Generally, patients spoke positively about the care and treatment they received. One patient said "Staff are attentive and always there when you need them”. They also said “The staff are so helpful if you want anything”.

Patients told us that they were involved in the planning of their care and that the staff were "Professional" and "Friendly". Patients provided positive feedback regarding the care they had received from staff in the Minor Injuries Unit. One patient said "I was seen so quickly. The staff gave me some very good advice and I would happily come back again".

Overall we found that the Provider had systems in place to ensure that the nutritional needs of patients was being met. However, we received mixed feedback regarding the availability of some food.

We observed good practices regarding infection control. We observed staff complying with good practice for the prevention and control of infection. The hospital was clean and tidy although we noted that some areas of the hospital could have benefited from redecorating; we considered that this did not have a negative impact on the quality or provision of care that was provided to patients.

Although the Provider was required to utilise agency nursing staff on a regular basis, the staff used were from a small cohort of nurses and were familiar with Caterham Dene Hospital. The Provider was able to demonstrate that the workforce used at Caterham Dene Hospital was able to provide consistent care to patients.

The Provider had systems in place for seeking feedback from patients which was used to monitor the quality and effectiveness of the service. This information was used to improve the service.

We saw several examples of people making choices about what they would like to wear or spend their time doing. This showed us that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We saw that the care records were inaccessible and inconsistent. Some care record information seen was incomplete and some care plans lacked clarity and detail. This could mean that people using this service were at risk of inappropriate care.

Staff told us that they were confident that they would recognise and knew what action to take if they observed an abusive situation. This showed us that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Records were seen of annual staff appraisals and additional training was provided based upon each person’s professional development plan (PDP). This meant that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Clinical governance was managed through the integrated governance committee. We saw the minutes of the integrated governance committee and saw that issues had been appropriately escalated to the board. This showed us that the provider had an effective system to regularly assess and monitor the quality of service that people receive.