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The Berkshire Independent Hospital Good

Inspection Summary


Overall summary & rating

Good

Updated 19 May 2020

The Berkshire Independent Hospital is operated by Ramsay Health Care UK Operations Limited . The hospital opened in 1993. It is a private hospital in Reading Berkshire. The hospital primarily serves the communities of Berkshire and the surrounding areas. The hospital also accepts patient referrals from outside this area. The hospital treated insured patients, those who were self-funded and NHS patients commissioned by East Berkshire, Oxfordshire and Berkshire West Commissioning groups.

The hospital has had a registered manager in post since December 2018. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage a service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how a service is managed.

Inspection areas

Safe

Good

Updated 19 May 2020

Are services safe?

Our rating of safe stayed the same. We rated it as Good because:

  • Staff completed and updated risk assessments for each patient to minimise risks. Staff identified and acted upon patients at risk of deterioration.
  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • The service had enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe and to provide the right care and treatment.
  • Managers regularly reviewed and adjusted staffing levels and skill mix, and gave bank and agency staff a full induction.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
  • The service-controlled infection risks well. The service used systems to identify and prevent surgical site infections. Staff used equipment and controlled measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.
  • 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.

However, we also found the following issues that the service provider needs to improve:

  • The service should follow good practice guidance and keep the clinical waste bins in the grounds locked to minimise risks of unauthorised access to sharps and other clinical waste.
  • There were carpeted areas at the service which may pose infection control risks as spillages including body fluids may not be adequately cleaned.

Effective

Good

Updated 19 May 2020

Are services effective?

Our rating of effective stayed the same.We rated it as good because:

  • The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance.
  • Staff followed national guidelines to make sure patients fasting before surgery were not without food for long periods.
  • Staff protected the rights of patients’ subject to the Mental Capacity Act 2005.
  • The endoscopy service had been accredited under Joint Advisory Group on gastrointestinal endoscopy (JAG) clinical accreditation scheme.
  • Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.
  • Staff gave patients enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary. The service adjusted for patients’ religious, cultural and other needs.
  • Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.
  • Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

Caring

Good

Updated 19 May 2020

Our rating of caring improved. We rated it as Good because:

  • Staff treated patients with compassion and kindness respected their privacy and dignity and took account of their individual needs.

  • Staff provided emotional support to patients, families and carers to minimise their distress. They understood patients’ personal, cultural and religious needs.

  • Staff knocked before entering patients’ bedrooms and when patients were in treatment areas and consulting rooms.

  • Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.

Responsive

Good

Updated 19 May 2020

Are services responsive?

Our rating of responsive stayed the same. We rated it as Good because:

  • The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care.
  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.
  • People could access the service when they needed it and received the right care promptly. The service admitted, treated and discharged patients in line with national standards.
  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. The service included patients in the investigation of their complaint.

Well-led

Good

Updated 19 May 2020

Our rating of well-led stayed the same.We rated it as Good because:

  • Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

  • The service had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy. Leaders and staff understood and knew how to apply them and monitor progress.

  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

  • Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events. Staff contributed to decision-making to help avoid financial pressures compromising the quality of care.

  • The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required.

  • Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.

  • All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them.

Checks on specific services

Medical care (including older people’s care)

Good

Updated 19 May 2020

Medical care services were a small proportion of hospital activity. The main service was Surgery. Where arrangements were the same, we have reported findings in the main service section.

We rated this service as good because it was safe, effective, caring, responsive and well led.

Surgery

Good

Updated 19 May 2020

Surgery was the main activity of the hospital. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section.

Staffing was managed jointly with medical care.

We rated this service as good because it was safe, effective, caring, responsive and well-led.

Diagnostic imaging

Good

Updated 19 May 2020

Diagnostic imaging services were a small proportion of hospital activity. The main service was Surgery. Where arrangements were the same, we have reported findings in the main service section.

We rated this service as good because it was safe, caring and responsive and well led. We currently do not rate effective for diagnostic imaging services.

Outpatients

Good

Updated 19 May 2020

Outpatient care services were a small proportion of hospital activity. The main service was Surgery. Where arrangements were the same, we have reported findings in the main service section.

We rated this service as good because it was safe, caring and responsive and well led. We currently do not rate effective for outpatient services.