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Nuffield Health Chichester Hospital Good

Inspection Summary


Overall summary & rating

Good

Updated 2 October 2017

Nuffield Health Chichester Hospital is an independent hospital which is part of Nuffield Health, a not for profit organisation. The hospital has six consulting rooms, 19 in-patient and 11 day-case beds and two laminar flow theatres. There is also an endoscopy suite and a dedicated gynaecology suite. It is situated in Chichester, West Sussex in a residential area.

The hospital provided a range of surgical services to private and NHS-funded patients from the local community. NHS patients accounted for an average of 40% of all patients.

We previously visited this hospital in July 2016 as part of our national programme to inspect and rate all independent healthcare providers. We inspected two core services at the hospital, which incorporated all the activity undertaken. These were surgery and outpatients, including diagnostic imaging.

Whilst we rated both core services and the hospital as ‘good’ overall, we found improvements were required to minimise risks and promote safety. We told the hospital it must:

  • Ensure infection control policies and standard operating procedures (SOP) are adhered to within theatres.

  • Ensure adequate availability of staff handwashing facilities in line with the Department of Health’s Health Building Note 00-09.

  • Ensure the sinks in patient rooms are compliant with the Department of Health’s Health Building Note 00-09: Infection control in the built environment.

  • Ensure compliance of record keeping in theatres relating to Misuse of Drugs Regulations 2001 and Safer Management of Controlled Drugs: a guide to good practice in secondary care (England).

  • Standardise and improve compliance with the ‘five steps to safer surgery’ (WHO) checklist.

  • Ensure that there is proper assurance of the safety, calibration, security and servicing of any privately owned clinical equipment brought into the hospital.

  • Ensure patients’ privacy and dignity is maintained at all times in theatre.

The hospital was in breach of three regulatory requirements:

  • Regulation 12 HSCA (RA) Regulations 2014 Cleanliness and infection control.

  • Regulation 17 HSCA (RA) Regulations 2014 Good governance.

  • Regulation 10 HSCA (RA) Regulations 2014 Dignity and respect.

We told the hospital that it must give us an action plan showing how it would bring services into line with the regulations. The hospital provided a comprehensive report on the actions it planned to take and updated us on progress, as the issues were resolved.

The purpose of the inspection on the 29th June 2017 was to see if the hospital had made the necessary changes outlined in the action plan provided. During this follow up inspection we focused on the action plan and the areas of concern which included some aspects of the surgery core service. We did not inspect any parts of the outpatient and diagnostic imaging core service.

We cannot re-rate these services due the time elapsed since the comprehensive inspection, therefore the rating for safe for surgery remains requires improvement. However, during this inspection we were assured that the hospital had met all the required improvements, recommendations and were no longer in breach of regulations.

The hospital had significantly improved and had taken action to comply fully with regulations and we found:

  • The hospital had an internal quality audit review following our inspection and showed us evidence of changes as a result of this.

  • The hospital had introduced a Standard Operating Procedure (SOP) for compliance with the uniform policy in theatres.

  • A new infection prevention co-ordinator had been employed and infection prevention link nurses worked in each department.

  • We saw evidence of plans to undertake refurbishments install handwashing facilities on wards to ensure adequate handwashing facilities for use by staff.

  • Staff training in Aseptic Non Touch Technique (ANTT) had been implemented and 90% of staff had undertaken the training.

  • Consultants were no longer bringing privately owned clinical equipment on site.

However:

  • We saw an improvement in the controlled drug registers; however, at the time of inspection these were not always correctly completed.

We will continue to monitor the performance of this service and inspect it again, as part of our ongoing programme.

Professor Edward Baker

Chief Inspector of Hospitals

Inspection areas

Safe

Requires improvement

Updated 2 October 2017

Effective

Good

Updated 2 October 2017

Caring

Good

Updated 2 October 2017

Responsive

Good

Updated 2 October 2017

Well-led

Good

Updated 2 October 2017

Checks on specific services

Outpatients and diagnostic imaging

Good

Updated 11 November 2016

We rated the outpatients and diagnostic imaging services provided at Nuffield Health Hospital Chichester as good, because:

  • There was a focus on patient safety within outpatient services. Medicines were stored safely and checks on emergency resuscitation equipment were performed routinely. Incidents and adverse events were reported and investigated through robust quality and clinical governance systems. Lessons arising from these events were learned and improvements had been made when needed.

  • There were sufficient staff with the right skills to care for patients and staff had been provided with induction, mandatory and additional training specific for their roles. Staff had appropriate safeguarding awareness and people were protected from abuse

  • People’s privacy was always protected in outpatient and diagnostic areas. Staff knocked on doors before entering rooms, used curtains appropriately and were careful to avoid conversations in corridors.

  • Patients’ treatment and care was delivered in accordance with their individual needs. Patients told us they felt involved in decisions about their care and they were treated with dignity and respect.

  • People’s concerns and complaints were listened and responded to and feedback was used to improve the quality of care.

  • The leadership, governance and culture within the departments promoted the delivery of person centred care. Staff were supported by their managers and were actively encouraged to contribute to the development of the services.

  • The method for tracking medical records was reliable and we saw innovative practice concerning sharing physiotherapy treatment notes between the hospital and the Nuffield Health Fitness & Wellbeing Centre, in Chichester as part of an integrated outpatient physiotherapy and rehabilitation service.

Surgery

Good

Updated 2 October 2017