Spencer Private Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people's care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we did not rate this key question. At this assessment, we rated this key question as good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people's care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Managers and staff showed us several assessment tools that were used in their assessment of patient needs at all stages of care.

Staff recorded patient needs clearly and aligned these to care plans. Staff ensured that patient needs from their pre-assessment had been included in their assessment plans. Patients reviewed and discussed their care plans to ensure they had an opportunity to contribute to their care. This included communication and wellbeing needs that patients may have needed during their stay.

Staff completed patient records on the ward that had up to date risk assessments for vital signs, falls, nutrition, skin integrity, and Venous thromboembolism (VTE) risk. VTE is the risk of a patient developing a blood clot after surgery.

Managers used an audit schedule to ensure staff were implementing and completing documentation that promoted a person-centred approach to care. These audits included personal care needs, patient repositioning, clinical needs and risk assessments. The audits completed promoted safe care which met the expected standards.

Managers completed the audit schedule every month. The audits showed good compliance with all areas.

The service planned and delivered people's care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Managers referenced National Institute of Care and Excellence (NICE) guidelines. Medical staff and managers followed accreditation schemes that enhanced evidence-based practice.

Staff showed a good understanding of evidence-based practice and understood national tools such as the malnutrition universal screening tool (MUST) and how to apply it. Staff were experienced and qualified to perform their roles and meet the needs of patients. Staff attended regular team meetings.

Managers provided staff with a suitable induction and ongoing appraisals associated with their work. Staff told us they had time to reflect and learn from their experiences when giving care.

Managers and staff showed their approach to nutrition by offering different menu choices for patients from different ethnic backgrounds. Patients gave positive feedback in this area of the annual patient experience report. Staff understood nutrition requirements for patients that had medical conditions such as diabetes and could refer to services such as Speech and Language Therapy (SALT) for patients who had swallowing difficulties.

Managers received and managed safety alerts efficiently. Safety alerts are notifications sent to providers that give them information they may need to consider action for. Managers explained that each alert was triaged and sent to the most suitable department head for distribution. Managers confirmed they had feedback mechanisms to show that the information had been received by tracking responses using a separate spreadsheet which highlighted any needed actions. For example, a national prompt was received for an epidural medication (This is a form of pain relief for some surgeries). The alert was sent to all medical consultants and anaesthetists.

Medical staff needed to gain approval for new procedures through the MAC if they wanted to introduce new practices This process ensured that any new procedures were suitable and up to date using evidence-based rationales.

The service did work well across teams and services to support people. Staff shared their assessment of people's needs when people moved between different services.

Staff worked closely with hospital teams both internally and externally. Staff welcomed collaborative working with multidisciplinary teams from the neighbouring NHS trust who helped support patient recovery.

Staff who cared for patients on the ward had access to their pre-assessment information. This supported them in making informed decisions about their needs in the ward environment. Staff knew what areas of care they handled and knew how to escalate queries and concerns.

Staff handed over key information about patients at handover meetings which meant patient needs were documented and discussed between shift changes.

Staff communicated patient needs with each other through face to face and telephone communication on the ward and pre-assessment areas. These conversations were performed discreetly and ensured confidentiality was kept.

The provider used the local NHS theatre suites, which were joined to the NHS hospital. Theatre utilisation was discussed at regular meetings with the hospital's leaders and the local NHS Trust. Theatre teams within the theatre department had effective working relationships and good communication with the provider.

Management teams met with local NHS trust managers to provide support for extra bed capacity. This included transferring patients that met the inclusion criteria of the hospital.

Managers would accept patients at short notice, and this was referred to as an unplanned transfer. There were 16 unplanned transfers in the past 12 months. Managers reported all unplanned transfers in their quality and safety report. Examples of unplanned transfers showed staff enforced their admission criteria to preserve the safety of patients. For example, if patients displayed an unsafe level of confusion on the ward, they would be transferred to a more suitable environment due to the ward having single rooms only. This meant that staff could not always ensure their safety.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff at the pre-assessment department took an interest in patients to make sure they were healthy enough to have the surgery they needed. For example, patients could not move beyond the pre-assessment phase of their assessment if a physical concern such as high blood pressure was identified. This meant that safety was prioritised at the earliest phase of care given.

Staff offered post operative guidance through leaflets and discharge documentation. Medical staff arranged follow up appointments when needed where further signposting for rehabilitation occurred.

Smoking and alcohol usage were used as parameters for the clinical risk to patients and this was assessed at both the pre-assessment and admission stages of treatment.

The service routinely monitored people's care and treatment to continuously improve it. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Managers and staff understood what positive outcomes looked like and contributed to schemes to support positive outcomes for patients.

Managers followed performance schemes such as the Patient Reported Outcome Measures (PROMS) and the National Joint Registry (NJR). Managers used these schemes to assess their performance and improve. Both registers, which included NHS and private patients, were designed to aid early reviews of patient groups for monitoring performance. This review included the implant, potential side effects and potential complications. The data also allowed patients to be contacted in case the implant was recalled for safety reasons.

Data from these schemes showed that the main surgical operations conducted at the hospital were hip and knee replacement surgery. Shoulder and ligament realignment surgery were also included in this data. Medical consultants followed the National Ligament Registry (NLR) and the Breast/Cosmetic Implant Registry (BCIR) to support data capture in this area.

The location received a silver award in December 2023 from National Joint Registry (NJR) and they contributed data to the Private Healthcare Information Network (PHIN) to look at further opportunities to improve outcomes for patients.

Staff showed an understanding of consent processes. Consent is the permission or agreement to perform something. Consent for operations was gained on the day of the procedure by the surgeon performing the operation. During our visit we saw completed consent forms. Consent forms were completed on the day of the procedure to allow patients a cooling off period after agreeing to the surgery.

Managers and staff knew when to consider mental capacity in the consent process and this was raised early during the pre-assessment phase of care. Patients had the opportunity to have an advocate with them at each phase of their treatment.

Managers had a consent policy that ensured processes were clear for staff to follow. Managers completed consent audits monthly which focused on the completion rate of consent forms for surgeries performed on the day of the operations. We reviewed these, and the service achieved 100% compliance.