Ropewalk House

Ropewalk House is part of Nottingham University Hospitals NHS Trust. Ropewalk House provides outpatient services; diabetic eye screening, audiology, and breast screening services.

Diabetic eye screening and audiology were provided to both adults and children. We inspected Ropewalk House on 15 September 2015 as part of the comprehensive inspection programme.

Overall, this trust was rated as Good. We made a judgements about the outpatient service as well as judgements about the five key questions that we ask. We rated the key questions “are services safe, effective, caring and well led as “Good.”

Our key findings were as follows:

Cleanliness and infection control • We found the hospital appeared clean. Staff cleaned their hands between patients and adhered to infection prevention and control policies and procedures. • Equipment was cleaned between use and waste was disposed of appropriately. Staffing levels • Outpatient clinics were staffed with appropriate numbers of staff, this was determined on how many consultants and patients were attending clinics.The skill mix of staff was considered. • Data from the trust showed staff turnover for medical and nursing staff at Ropewalk House was low. Bank and agency usage was also low. Patients were able to build relationships with staff and receive continuity of care. • There were enough medical staff employed to run clinics at Ropewalk House. There were no medical staffing vacancies. Safety • Staff knew how to report incidents and these were investigated with actions and learning identified where necessary. • There was a strong open culture and staff were encouraged and supported to report incidents. • Learning from incidents was shared through team meetings. We saw examples of changes being made following the learning from incidents. • Incidents relating to ophthalmology (eyes) were reported to the national eye screening incident board so incidents and performance safety could be monitored nationally. • Trusts are required to report any unnecessary exposure of radiation to patients.

The breast screening service met both Ionising radiation regulations 1999 (IRR99) and Ionising radiation (medical exposure) regulations 2000 (IR(ME)R). Procedures were in place to report incidents to the correct organisation ensuring a review of practices when incidents occurred. • All staff knew the whereabouts of all relevant procedural documentation including local rules, IR(ME)R procedures and trust policies