Rivers Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. We checked that people were safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination.

At our last assessment we rated this key question good. At this assessment the rating remains good.

This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events.

The service managed patient safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. Managers ensured actions from patient safety incidents were addressed and progress was monitored.

The service had a current incident reporting and reviewing policy, which reflected the provider and national guidance. Staff raised concerns and reported incidents and near misses in line with provider’s policy.

The service provided mandatory training in key skills to all staff. Data showed us that 42% of staff in the chemotherapy service and 32% of staff in the endoscopy service had overdue training modules. We saw an action plan to improve compliance by the end of 2026.

There had been no reported never events in the preceding year. Never events are serious, preventable safety incidents which should not occur if the available preventable safety measures are followed.

Staff told us they were able to identify and report risks. Where there was an immediate risk of harm to patients or others, staff felt confident to intervene to prevent harm from occurring.

Staff we spoke to understood their responsibility for duty of candour. Duty of candour is a legal requirement for all health and social care providers to act in an open and transparent way with people receiving care. This means when something goes wrong that causes, or could cause, significant harm, the provider must inform the persons (or their family), explain what happened, offer an apology and outline next steps. There was an up-to-date policy in place, and we saw evidence of it being applied appropriately.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Patients were assessed prior to treatment, and findings were considered when planning care and treatment. The service had admission criteria for both private and NHS patients. These criteria set out the service limitations and reduced risks by excluding some patients, such as those with high risk of needing additional support.

When overall responsibility for a patient’s care and treatment transferred to another service provider, such as the NHS, this was carried out under an established agreement with the local NHS provider. Whenever a patient required transfer, a review was undertaken to support ongoing learning and improvement.

All patients we spoke with were positive about safe care and continuity. For example, a patient who had used the service for many years told us they had always felt safe and never needed to explain their condition or treatment plan because staff were always informed and prepared for them on admission.

The service used National Early Warning Score 2 (NEWS2) as a standardised system to detect early signs of clinical deterioration in adult patients, and we observed this being used during our inspection.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

Staff knew how to make a safeguarding referral and who to inform if they had concerns. Expert safeguarding advice was available to support staff from the safeguarding lead. Staff knew how to contact them.

Staff understood how to protect patients from abuse. Staff received adult and children's safeguarding level 3 training. Compliance for endoscopy staff was 100% and for chemotherapy staff 80%. The service had an action plan to improve compliance by the end of 2026. There were current safeguarding policies, and these reflected the national guidance for adults and children, including visitors.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The service worked with patients to understand and manage risks. Treatment and care met patients' needs in a way that was safe and supportive and enabled them to do the things that mattered to them.

Staff understood how to identify and manage risks. They told us that risk assessments and any changes were discussed with patients, their relatives and or carers but the Electronic Patient Record (EPR) system was difficult to use to regularly update risk assessments. There was no evidence this had caused harm to patients.

The service had policies in place to support staff with understanding and managing patient risks and deterioration. This included National Early Warning Score 2 (NEWS2) and Observation policy for the management of acutely unwell adults. The service completed an audit of NEWS2 compliance. Compliance in February 2026 was 84.9% and this increased to 92.2% in April 2026. We observed good compliance with the recording of NEWS2 in patient records we looked at.

Patients told us they felt listened to, risks had been explained and they were involved in decisions about their care and treatment.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The environments used to provide medical care reduced the risk of patient harm and included features such as safe flooring and handrails.

Fire safety equipment was available and had been serviced. Staff kept fire exits clear and free from obstruction.

Equipment was visibly clean and well maintained. Staff told us that all items of equipment were readily available and any faulty equipment was repaired or replaced in a timely manner. Documents demonstrated that staff recorded and monitored equipment servicing repairs.

Staff undertook daily safety checks of specialist equipment. Emergency resuscitation equipment was available in the areas we inspected, and daily and weekly equipment check logs were complete and up to date. All the emergency resuscitation trolleys were tagged to minimise the risk of tampering.

Staff managed cytotoxic waste safely and in accordance with the providers policy.

We scored the service as 3. The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service employed sufficient clinical staff, including nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide effective care and treatment. Staff received advance notice of their shifts and could request changes where needed.

Staff we spoke with said they felt the service was safe and they were able to take breaks during their shifts.

Patients we spoke with told us staff met their needs in a timely manner, and throughout our inspection, we observed staff responded quickly to patients needs. We saw staff attend to patients in a kind and supportive way. Patients looked comfortable and were engaged in conversations with staff, which reflected adequate staffing levels.

A specialist oncology pharmacist provided support and managed chemotherapy medicines, which ensured timely access to specialist advice when needed.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service managed infection risks well. Staff used equipment and control measures to protect patients, themselves, and others from infection. They kept equipment and the premises visibly clean.

Staff maintained clinical areas in a clean and clutter-free condition. These areas had suitable furnishings that were clean and well-maintained.

Staff cleaned equipment after patient contact and labelled it to show when it was last cleaned.

We observed staff following infection prevention and control principles, including handwashing and the correct use of personal protective equipment (PPE). Staff working in clinical areas were bare below their elbows to allow for full hand decontamination.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happen.

Staff administered medicines safely and in line with prescribed times.

Staff completed medicines risk assessments, including assessments for venous thrombolytic embolism (VTE), and prescribed appropriate prophylaxis if needed.

Staff stored medicines, including controlled drugs, securely and checked them regularly.

Staff told us pharmacy support helped ensure people had access to medicines they required, supporting continuity and safe supply. The service had access to specialist oncology pharmacy support, including an oncology specialist technician and pharmacists who managed chemotherapy medicines, which ensured timely access to specialist advice when needed.

Cytotoxic medications were stored and handled safely. Staff used an electronic chemotherapy prescribing system and there were robust systems in place to check chemotherapy medications before they were administered. The pharmacy only dispensed chemotherapy medications once the patient’s blood results had been checked and confirmed as suitable for chemotherapy treatment.