Safe Staffing 2014

December 2014

All ward areas continue to work hard to fill vacant posts and manage all internal staffing pressures. Mitigating actions this month included, staff qualified, with a PIN and on shift but still on preceptorship, use of bank staff and staff working extra hours to rostered shift, staffing working flexibly across 2 ward sites to respond to patient dependency, restricting leave over Bank holidays and restricted admissions short term or bed closures. Two wards  have also redeployed staff to ensure any temporary restricted/closed beds could be safely opened by month end, due to the escalation of winter pressures. All areas following mitigation actions are reporting internally safe staffing levels.

 Staffing Levels in our Community Hospitals - December 2014


November 2014

Five out of six hospital wards failed to achieve 100% staffing across all shifts during November, ward staff managed the workload and escalated concerns accordingly to ensure safe levels. Recruitment continues to be a challenge and recruitment is ongoing across all inpatient areas.

Mitigating actions this month included, staff qualified, with a PIN and on shift but still on preceptorship, use of bank staff and staff working extra hours to rostered shift, staffing working flexibly across 2 ward sites to respond to patient dependency, restricted admissions short term or  bed closures. Due to the location of our community hospitals, ward staff have also facilitated a bespoke recruitment campaign within the local area open to all registered staff and students.

All areas following mitigation actions are reporting internally safe staffing levels for patients under their care.

 Staffing Levels in our Community Hospitals - November 2014


October 2014

5 out of 6 hospital wards failed to achieve 100% staffing across all shifts during October, ward staff managed the workload and escalated concerns accordingly to ensure safe levels. Recruitment continues to be a challenge and is ongoing.

Mitigating actions this month included, staff qualified, with a PIN and on shift but still on preceptorship, use of bank staff and staff working extra hours to rostered shift, staffing working flexibly across 2 ward sites to respond to patient dependency, restricted admissions short term or  bed closures. All areas following mitigation actions are reporting internally safe staffing levels.

 Staffing Levels in our Community Hospitals - October 2014


September 2014

All hospital wards did not achieve 100% staffing across all shifts during September, ward staff managed the workload and escalated concerns accordingly to ensure safe levels. Recruitment continues to be our biggest challenge and is ongoing.

Mitigating actions this month included, staff qualified, with a PIN and on shift but still on preceptorship, use of bank staff and staff working extra hours to rostered shift, staffing working flexibly across 2 ward sites to respond to patient dependency, restricted admissions short term or bed closures. All areas following mitigation actions are reporting internally safe staffing levels.

 Staffing Levels in our Community Hospitals - September 2014


August 2014

Louth Hospital - Manby Ward - all 32 beds open

  • Increase in day registered hours - 89.8% (88.9%)
  • Decrease in day carer hours - 82% (87.6%)
  • Decrease in night registered hours - 75.8% (83.2%)
  • Decrease in night carer hours - 88.7% (100%) 

Louth Hospital - Carlton Ward - all 24 beds and 6 chairs open

  • Increase in day registered hours - 90.9% (67.4%)
  • Increase in day carer hours - 100% (94.8%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 50% (50%) 

Additional narrative

  • Manby Ward fill rates for Registered Nurses across days and nights is between 75.8% (Nights) and 89.8% (Days) - 1.0 WTE RN recruited starts in Sept awaiting PIN (should start in Oct as RN) , 3.0 WTE posts are currently out to recruitment.  1.8 WTE RN remain on long term sick.
  • Manby Ward fill rates for Care Workers on Days is 82% - 2.0 WTE Carer appointed and on September induction. 1.4wte remain on Long term sick
  • Staffing levels on both wards has continued to be supplemented by Bank and staff working extra hours. No shifts, stand out as low especially low as staff rotas have been managed across both wards over the month. Ward areas are also utilising band 4 staff to enhance level of unregistered care.
  • Carlton Ward fill rates for registered nurses on days has improved to, 90.0%  - 1.0wte starts in Sept awaiting PIN (should start in Oct RN). 0.6 WTE RN started on Aug Induction.  The remainder of the WTE is currently back out to advert. There is 1 registered member of staff on long term sick leave.
  • Carlton Ward fill rates for Care Staff across days and nights is between 50% (nights) and 100% (days).  0.8 WTE  Carer who started in on Aug and another 1.0WTE who starts 8th Sept. This will bring the staffing up to establishment.
  • Carlton ward staffing was consistently at the level declared throughout the month. There were no days where either the HCSW or the trained staff were less in number than any other as the wards at Louth had worked together to cover the shifts to the best of their ability whilst recruiting up to the safe staffing numbers.  Carlton ward has 6 chairs this does give an additional opportunity to flex staff over both wards on site overnight as need arises.

Skegness Hospital - Scarborough Ward - all 15 beds open

  • Decrease in day registered hours - 92.5% (96.8%)
  • Increase in day carer hours - 95.5% (83.9%)
  • No change in night registered hours - 100% (100%)
  • Increase in night carer hours - 100% (96.6%)

Skegness Hospital - Gloucester Ward - 21 of the 24 beds open

  • Decrease in day registered hours - 86.5% (97.4%)
  • Increase in day carer hours - 111.0% (100.6%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 100% (100%)

Additional narrative

  • Scarborough Ward fill rates for care staff on Days has increased to is 95.5%, Gloucester ward day fills rates have increased to 111% to support the decrease in Day registered Hours - Recruitment has taken place for 5.0 WTE all starting in September post induction (3 x WTE on Scarborough ward and 2 WTE on Gloucester ward).  1.0 WTE Band 5 vacancies remains out to advert at present.  Interviews for 6.07 WTE HCSW working across both wards are scheduled to take place within the next two weeks and they should be on the September induction.
  • Lowest staffing point in the month, is not significant as the two sets of wards work collaboratively together to cover staffing between the two wards so no particular shifts that "stand out" as being particularly low on staffing numbers or below safe limits for the patients on the ward at the time.

John Coupland Hospital - all 23 beds open however escalation process has been used and beds available has been restricted during the month

  • Increase in day registered hours - 72.2% (66.1%)
  • Decrease in day carer hours - 131.8% (142.7%)
  • Increase in night registered hours - 101.6.0% (100%)
  • Increase in night carer hours - 57.3% (50.0%)

Additional Narrative:

  • Deficit in registered hours has been mitigated by clinically basing discharge professional leads and staff on preceptorship (not allowed to be included in the return criteria). Currently the ward has 2 x registered staff starting September.  Recruitment is ongoing for X1 band 5 nurse and 1.4wte HCSW.
  • Bank staff are requested where possible and staff have been offered additional hours. The ward continues to be down on night time HCSW numbers working on 2/1 instead of 2/2 to support the day time activity and current short fall, hence carer fill rates for day shifts has increased. 11 day shifts utilised increased carer hours 2/4 instead of 3/3 ratio. X1 night shift had trained staff only available to maintain safe staffing numbers, due to a deficit of carer hours, however this will have impacted on hours available during the day.
  • Lowest staff point in the month was 1 trained staff on the early shift with 3 care staff plus 1 extra staff member doing early and 1 doing twilight 1/5 on 1 occasion only (staffing should be 3/3 days minimum)  

Johnson Community Hospital - 21 of the 32 beds open

  • Decrease in day registered hours - 93.3% (100%)
  • Increase in day carer hours - 127.8% (91.0%)
  • Decrease in night registered hours - 68.8% (74.6%)
  • Increase in night carer hours - 100% (96.8%)

Additional Narrative:

  • The new Ward Manager is now established. Recruitment of registered nurses is ongoing with plans to incrementally open additional beds. 1 WTE starting induction in September, 2 WTE starting induction in October. In addition 2.2wte carers start induction in October. Presently the ward has 1.8 WTE Registered Nurses on long term sick leave with additionally a number of episodes of short term sickness in August

The risk to achieving this is the availability of therapy staff on the ward as the current establishment is not sufficient to meet the needs of 28 patients.

  • Discussions are taking place with commissioners regarding future utilisation of the remaining 4 beds, and it is hoped to obtain agreement to use some of the funding associated with these 4 beds to employ additional therapy staff which will have a positive impact on quality of care and length of stay.
  • Night trained fill rate is reported at 68.8% However the ward had no low staffing levels in August as the ward had 2 trained staff on the night shift as 1.6 wte nurse remain on preceptorship, she was not included in the data return. Increase in day carer numbers supported the deficit in day registered hours the ward manager and advanced Nurse Practitioner have supported clinical duties as required.
  • Staffing levels have not provided any clinical risk.

Butterfly Hospice - 1 bed open mid month

  • Baseline in day registered hours - 100%
  • Baseline in day carer hours - 100%
  • Baseline in night registered hours - 100%
  • Baseline in night carer hours - 100%

LCHS overall position

  • Increase in day registered hours - 88.0% (85.2%)
  • Increase in day carer hours - 105.0% (99.9%)
  • Decrease in night registered hours - 88.9% (90.3%)
  • Increase in night carer hours - 81.7% (79.0%)

 Staffing Levels in our Community Hospitals - August 2014


July 2014

Louth Hospital - Manby Ward

  • Increase in day registered hours - 88.9% (84.6%)
  • Decrease in day carer hours - 87.6% (88.3%)
  • Decrease in night registered hours - 83.2% (84.6%)
  • Increase in night carer hours - 100% (98.4%)

Louth Hospital - Carlton Ward

  • Decrease in day registered hours - 67.4% (83.9%)
  • Increase in day carer hours - 94.8% (86.3%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 50% (50%)

Registered Nurse (RN) vacancy:

  • 2.0 WTE newly qualified RN to start in September, but awaiting registration number
  • 2.0 WTE posts being shortlisted mid August  
  • 0.6 WTE started on August Induction  
  • Further advert placed for the remainder of the vacant hours

Registered Nurse sickness:

  • 3 WTE on long term sick leave

Care Worker vacancy:

  • 0.8 WTE started on the 11th August
  • 3.0 WTE scheduled to start on Induction in September
  • This will bring the staffing up to planned levels  

Skegness Hospital - Scarborough Ward 

  • No change in day registered hours - 96.8% (96.8%)
  • Decrease in day carer hours - 83.9% (87.1%)
  • No change in night registered hours - 100% (100%)
  • Decrease in night carer hours - 96.6% (100%)

Skegness Hospital - Gloucester Ward

  • Increase in day registered hours - 97.4% (74.8%)
  • Increase in day carer hours - 100.6% (109%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 100% (100%)

Registered Nurse (RN) vacancy:

  • 5.4 WTE are due to be interviewed in August with expected start date of September

Registered Nurse sickness:

  • 2 WTE on long term sick leave

Care Worker vacancy:

  • 0.8 WTE started on the 11th August
  • 1.0 WTE scheduled to start on the 8th September
  • This will bring the staffing up to planned levels  

John Coupland Hospital

  • Decrease in day registered hours - 66.1% (100%)
  • Increase in day carer hours - 149.7% (92.1%)
  • Increase in night registered hours - 100.0% (98.3%)
  • Decrease in night carer hours - 50.0% (103.3%)

Registered Nurse (RN) vacancy:

  • 2 WTE starting induction September
  • New starters will be on the September and October off duties, one of them is newly qualified and undertaking preceptorship
  • Recruitment underway for band 5 staff nurse positions, 1.4 WTE

Registered Nurse sickness:

  • 1  WTE on long term sick leave

Care Worker sickness:

  • 1 WTE on long term sick and then planned maternity

Care Worker vacancy:

  • Recruitment underway for September WTE 1.4
  • Expected to be at planned establishment levels by October

Johnson Community Hospital

  • Increase in day registered hours - 100% (107.5%)
  • Decrease in day carer hours - 91.0% (94.8%)
  • Decrease in night registered hours - 74.6% (98%)
  • Increase in night carer hours - 96.8% (98.4%)

Registered Nurse (RN) vacancy:

  • 1.6 WTE newly qualified registered nurses undertaking their Preceptorship therefore they are not included in the data return
  • 1 WTE starting induction in September
  • 2 WTE starting induction in October

Registered Nurse sickness:

  • 1.8 WTE on long term sick leave

Care Worker vacancy:

  • 2.2 WTE starting induction in October

LCHS overall position

  • Decrease in day registered hours - 85.2% (89.4%)
  • Increase in day carer hours - 99.9% (92.2%)
  • Decrease in night registered hours - 90.3% (95.1%)
  • Decrease in night carer hours - 79.0% (89.6%)

  Staffing Levels in our Community Hospitals - July 2014 


 

June 2014

Key elements to note in relation to individual hospital sites are as follows with the previous months figures in brackets:

Louth Hospital  "Manby Ward" all 32 beds open

  • Slight deterioration in day registered hours - 84.6% (89.5%)
  • Slight improvement in day carer hours - 88.3% (86.8%)
  • Slight deterioration in night registered hours - 84.6% (89.4%)
  • Slight deterioration in night carer hours - 98.4% (100%)

Louth Hospital “Carlton Ward" all 24 beds and 6 chairs open

  • Significant improvement in day registered hours - 83.9% (38.9%)
  • Slight deterioration in day carer hours - 86.3% (89.9%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 50% (50%)

Additional Narrative:

We are actively recruiting to fill vacancies and hope to have new staff in post next month.

Skegness Hospital - Scarborough Ward - all 15 beds open

  • Slight deterioration in day registered hours - 96.8% (106.5%)
  • Improvement in day carer hours - 87.1% (82.2%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 100% (100%)

Skegness Hospital - Gloucester Ward - 21 of the 24 beds open

  • Slight deterioration in day registered hours - 74.8% (79.4%)
  • Improvement in day carer hours - 109% (100.6%)
  • No change in night registered hours - 100% (100%)
  • No change in night carer hours - 100% (100%)

Additional Narrative:

We are actively recruiting to fill vacancies and hope to have new staff in post next month.

John Coupland Hospital - all 23 beds open

  • Slight improvement in day registered hours - 100% (97%)
  • Deterioration in day carer hours - 92.1% (129.7%)
  • Slight improvement in night registered hours - 98.3% (97%)
  • Deterioration in night carer hours - 103.3% (129.8%)

Additional Narrative:

We are actively recruiting to fill vacancies and hope to have new staff in post next month.

Johnson Community Hospital - 21 of the 32 beds open

  • Improvement in day registered hours - 107.5% (99%)
  • Slight deterioration in day carer hours - 94.8% (96.9%)
  • Slight deterioration in night registered hours - 98% (98.4%)
  • Slight deterioration in night carer hours - 98.4% (100%)

Additional Narrative:

Deficits are a result of episodes of short term sickness which are no longer an issue. Deficits in day carer hours have been mitigated by registered nurse hours. The deficits overnight as a result of the short term sickness have been mitigated by staff working additional hours.

We are actively recruiting to fill vacancies and hope to have new staff in post next month.

LCHS overall position

  •  Improvement in day registered hours - 89.4% (82%)
  • Slight deterioration in day carer hours - 92.2% (97.1%)
  • Slight deterioration in night registered hours - 95.1% (96.4%)
  • Slight deterioration in night carer hours - 89.6% (94.2%)

  Staffing Levels in our Community Hosptials - June 2014


May 2014  

Louth Hospital

The trust is aware of the low staffing numbers in relation to Carlton Ward - this is due to a number of vacant posts which are actively being recruited to.  In the interim, daily risk assessments are taking place, with staff from the nurse bank and other parts of the hospital providing additional support.

Skegness Hospital

The trust is aware of the lower number of registered staff on Gloucester Ward.  This is again due to vacancies which are actively being recruited to.  The ward is being supported by the nurse bank and an increased number of experienced unregistered staff.

John Coupland / Johnson Hospitals

The trust has no immediate concerns in relation to the number of staff available, but continues to monitor the situation on a daily basis.

 Staffing Levels in our Community Hospitals - May 2014