• Hospital
  • Independent hospital

Winfield Hospital

Overall: Good read more about inspection ratings

Tewkesbury Road, Longford, Gloucester, Gloucestershire, GL2 9WH (01452) 331111

Provided and run by:
Ramsay Health Care UK Operations Limited

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Background to this inspection

Updated 5 August 2022

Winfield Hospital is part of the Ramsay Healthcare group providing surgery and outpatient services for NHS, self-funding and private patients. The hospital is situated on the outskirts of Gloucester and most patients live in the city and local area.

There are currently 38 inpatient beds on one ward which are used for overnight and day care patients, three operating theatres and an outpatient department. Services provided include general surgery, gastroenterology, urological and gynaecological surgery, orthopaedic surgery (such as total hip and knee replacement), ear, nose and throat, spinal, ophthalmology, bariatrics, oral and maxilla-facial, cosmetic and plastic surgery. The service also admits cardiology patients requiring cardioversion. Patients are treated on a day case basis or are accommodated on the ward.

Outpatient services provide consultant-led clinics in a range of specialities. There are also nurse-led preadmission clinics and general nurse appointments for services such as removing dressings, sutures and plasters. There are 11 consulting rooms and two treatment rooms. Diagnostic imaging services include plain film X-ray, fluoroscopy and ultrasound. There are also mobile services provided on site by Ramsay UK Diagnostics for magnetic resonance imaging (MRI) and for computed tomography (CT). Physiotherapy services are provided to outpatients and inpatients. Facilities include a gymnasium and services include hydrotherapy, treatment of sports injuries, ultraviolet treatments, musculoskeletal assessment and treatment and post-operative rehabilitation.

Between May 2021 and May 2022, 5,433 patients had surgical treatment, readmission rate was less than 1 in 1,000 (0.0009%).

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

The provider is registered to provide the following regulated activity:

  • Diagnostic and screening procedures.
  • Treatment of disease, disorder or injury.
  • Family planning.
  • Surgical procedures.

The location has a registered manager who has been in post since 2016. Registered managers have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations.

The provider employs 156 permanent staff and 138 Consultants have practicing privileges.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 7 and 8 June 2022.

The hospital was last routinely inspected in August 2016 and was rated as requires improvement overall with requires improvement in the safe, responsive and well led domains. A focused follow up inspection was subsequently completed in February 2018 to review requirements identified at the 2016 inspection.

The main service provided by this hospital was surgery. Where our findings on surgery for example, management arrangements, also apply to other services, we do not repeat the information but cross-refer to the surgery service.

Our rating of the location improved. We rated it as good overall because:

  • Surgery has been rated as good overall.
  • Diagnostics and screening procedures have been rated as good overall.
  • Outpatients has been rated as good overall.

Overall inspection

Good

Updated 5 August 2022

Our rating of this location improved. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

  • Not all staff had complete updates to the mandatory training as required by the service’s policy. There was no formalised training for mental health and learning disabilities.
  • Ward staff did not always label equipment to show when it was last cleaned.
  • There were policies that required review to ensure they contained up-to-date guidance and were still relevant. The service did not always ensure consultants curriculum vitae were compliant with its practising privileges policy.
  • Not all equipment had been serviced in line with manufacturer and policy requirements. Consumables were not always removed when packaging had degraded.
  • Storage areas for consumables were not always locked.

Diagnostic imaging

Good

Updated 5 August 2022

We rated all key questions for diagnostic and screening services apart from effective as defined within our methodology.

Our previous rating included a joint rating of outpatients and diagnostic and screening services, we have rated them independently as part of this inspection.

Our rating of this service improved. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available to suit patients' needs.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

  • Not all staff had complete updates to the mandatory training as required by the service’s policy.
  • There was a consumables storage room in the department that was not always locked.

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

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

Outpatients

Good

Updated 5 August 2022

The outpatient department is open between 8.00am and 9pm Monday to Friday. On the first Saturday of the month, it opens for clinics between 8.30am – 1pm. Consultants provided clinics covering a number of areas which included audiology, cardiology, cosmetics & plastics, dermatology, gastroenterology, general surgery, gynaecology, general and renal medicine, neurology, ophthalmology and orthopaedics. The physiotherapy department was open for outpatient services from Monday to Thursday.

The outpatient’s department had a total number of 5,201 appointment visits during the period July 2021 to June 2022 of which, 53% were NHS appointments. The service treated adults and did not treat children.

This was the first inspection of outpatients as a standalone service. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

  • Not all staff kept up-to-date with mandatory training. Only 41% staff had completed basic life support training.
  • Ophthalmology equipment required servicing and was still in use 7 months past its servicing date requirement.
  • There were policies that required review to ensure they contained up-to-date guidance and were still relevant.

Surgery

Good

Updated 5 August 2022

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

  • The service had enough staff to care for patients and keep them safe. Staff understood how to protect patients from abuse, and managed safety well. The service usually controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

  • Staff did not always complete mandatory training. There was no formalised training for mental health and learning disabilities.
  • Ward staff did not always label equipment to show when it was last cleaned.
  • The service did not always ensure consultants curriculum vitae were compliant with its practising privileges policy.