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BMI Bath Clinic Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 31 July 2018

BMI Bath Clinic is operated by BMI Healthcare Limited. The hospital has an outpatients department, which provides diagnostic and screening services, including an MRI scanner. There are three operating theatres and an endoscopy unit.

The hospital provides surgery, medical care including oncology, outpatient and diagnostic services. Specialties include general surgery, orthopaedic surgery, ear, nose and throat procedures, gynaecology, oncology treatment, ophthalmology and urology services.

We previously inspected this hospital in May 2016 and gave it an overall rating of requires improvement. We inspected this service, unannounced, on 15 May 2018 using our focused inspection methodology. This inspection focused on specific parts of the service that were identified as needing improvement at our last inspection.

The key questions we asked during this focused unannounced inspection were, was it ‘Safe’ in outpatients and diagnostics and was it ‘Well Led’ in medicine, surgery, outpatients and diagnostics.

We were not able to change the overall rating of this hospital as this inspection only focused on the specific areas that were identified at the last inspection as needing improvement.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

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

Services we rate

We have rated this hospital overall as Requires Improvement.

We found good practice in relation to outpatient and diagnostics care:

  • The service managed staffing effectively and services always had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
  • Outpatients and diagnostic environments were visibly clean and well maintained and there were measures to prevent the spread of infection.
  • Systems had been implemented to keep patients safe and to learn from serious incidents.
  • There was a comprehensive system for the management of quality and governance and managers were aware of the risks and challenges they needed to address.
  • There was a designated lead for safeguarding children and vulnerable adults. Staff were trained appropriately to recognise and report suspected abuse.
  • Patient records were maintained in one place, up to date and stored securely.
  • Medicines were managed safely and stored securely.
  • Risks were identified and managed with ongoing monitoring and review.

We found good practice in relation to medicine and surgery:

  • There was a comprehensive system for the management of quality and governance and managers were aware of the risks and challenges they needed to address.
  • Risks were appropriately identified, recorded, monitored and actions taken to minimise these.
  • There were systems to keep patients safe and to learn from serious incidents and complaints.
  • For surgery an enhanced recovery programme had been reviewed and changes made to meet the needs of patients.

We found areas of practice that require improvement in outpatients and diagnostics.

  • Not all staff were aware who the safeguarding lead for the hospital was.
  • Feedback to staff from simulation events of patient emergency did not always take place.
  • There was no system that enabled leaders to obtain evidence from staff when they had completed mandatory training with other health care providers.
  • Not all staff were up to date with fire awareness training.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (South)

Inspection areas

Safe

Good

Updated 31 July 2018

Outpatients and diagnostic imaging only

We found the following areas of good practice:

  • The service managed staffing effectively and had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
  • The environment in outpatients and diagnostic imaging was visibly clean and well maintained. Changes had been made following our last inspection to prevent the spread of infection.
  • Learning took place following incidents to keep patients safe and to meet their needs.
  • There was a designated lead for safeguarding children and vulnerable adults and staff were trained to recognise and report suspected abuse.
  • Changes to the patient records system meant that each patient had just one set of records.
  • Medicines were managed safely and stored securely.

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

  • Not all staff were aware of who the lead person was for safeguarding.
  • Feedback from simulation events of a cardiac arrest did not always take place.
  • Not all staff were up to date with fire awareness training.

Effective

Good

Updated 31 July 2018

Caring

Good

Updated 31 July 2018

Responsive

Good

Updated 31 July 2018

Well-led

Good

Updated 31 July 2018

We found the following areas of good practice:

  • Staff were aware of the vision and strategy of the provider.
  • There was a comprehensive system for the management of quality and governance and managers were aware of the risks and challenges they needed to address.
  • Risk were appropriately identified, recorded, monitored and actions taken to minimise these.
  • There were systems to keep patients safe and to learn from critical incidents and complaints.
  • For surgery an enhanced recovery programme had been reviewed and changes made to meet the needs of patients.

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

  • There was no system that enabled leaders to obtain evidence from staff when they had completed mandatory training with other health care providers.
Checks on specific services

Medical care (including older people’s care)

Good

Updated 31 July 2018

Where arrangements were the same, we have reported findings in the surgery section.

We inspected the well led domain only and this was rated as good. 

Outpatients and diagnostic imaging

Good

Updated 31 July 2018

Where arrangements were the same, we have reported findings in the surgery section.

We inspected safe and well led domains only and these were rated as good.

Surgery

Good

Updated 31 July 2018

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.

We inspected the well led domain only and this was rated as good.