This report includes the evidence we gathered on our visit to two services provided at the hospital, Scotter Ward, a 23 bed in-patient ward and the nurse led Minor Injuries Unit.

We spoke with six patients, eight members of staff, senior managers as well as two relatives of patients who were visiting Scotter Ward. We also looked at some records and other information that was provided to us by the trust.

We saw that patient’s needs were assessed and their care planned and clearly documented. Patients we spoke with said they were happy with the care they were getting, felt staff were kind and that they were treated with dignity and respect.

Some members of staff informed us they did not think there was enough nursing staff on duty on Scotter ward at times and this could impact on staff morale but that the care delivered to patients was not adversely affected. One member of staff told us, “Staffing levels can be challenging but patient care never suffers.”

Staff told us they felt supported to do their job and we saw both mandatory and specialist training had been put in place, but staff told us that they felt there was a need for additional training in caring for patients with dementia on Scotter Ward.

The trust had systems and processes for monitoring the quality of care. Incident reporting was seen to be robust and the trust board took an active approach in investigating serious untoward incidents. As a result of this, risks to patients were reduced.

Lincolnshire Community Health Services NHS Trust provided out-of-hours General Practitioner (GP) services for patients living in Lincolnshire. The service was administered from the trust’s headquarters in Sleaford and patient care and treatment was provided from eight primary care centres at locations across the county. We visited the trust’s headquarters on 5 June 2014 where we looked at records and information and talked with staff about issues that related to all eight locations and the service a whole. On the 7 June 2014 we visited the primary care centre at John Coupland hospital and spoke with members of staff, patients and carers and reviewed documents and matters specific to that location.

Lincolnshire Community Health services NHS Trust (referred to in this report as ‘The provider’) provides OOH GP services for patients living across Lincolnshire from eight locations. We have inspected the eight locations and this reports is in relation to our inspection of the location at John Coupland Community Hospital

The provider conducted clinical audit that addressed specific areas of patient care. Individual clinicians’ practice was assessed on a regular basis to help ensure that patients received safe and effective care and treatment.

We found the service was effective in meeting patients’ needs and the primary care centres were accessible to those who may have had mobility issues.

The reception used Language Line for interpretation purposes if required. They had a laminated sheet available in numerous languages for patients to identify the language they spoke. There was a book available specifically to assist Polish speaking patients. Lincolnshire has a large number of resident Polish migrant workers.

There were systems in place to help ensure patient safety through learning from incidents and infection prevention and control.

Staff were trained and supported to help them recognise the signs of abuse of children and vulnerable adults.

The provider had not used effective recruitment processes to assess the suitability of staff to work in this sector. We have told the provider they must improve

Patients experienced care that was delivered by dedicated and caring staff. Patients and carers we spoke with said staff displayed a kind and caring attitude and we observed patients being treated with respect and kindness whilst their dignity and confidentiality was maintained.

The provider had in place business continuity and contingency plans that would enable the service to continue to operate in the event of a failure of, for example, the information technology or telecommunication systems.

We found that the service was well-led and managed by a knowledgeable senior management team and Board of Directors at provider level. They had taken action to help ensure their values and behaviours were shared by staff through regular engagement.

At John Coupland Community Hospital out-of-hours there was only one GP on duty. The GP told us that he felt supported by the clinical lead and held positive views of the management team and their leadership. He told us the senior managers were approachable and listened to any concerns or suggestions he might have to improve the level of service provided to patients.