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Inspection Summary


Overall summary & rating

Good

Updated 23 July 2019

BMI The Park Hospital is operated by BMI Healthcare Limited. The hospital has 66 beds. Facilities include five operating theatres, a five-bed level two care unit, and X-ray, outpatient and diagnostic facilities.

The hospital provides surgery, medical care and outpatients and diagnostic imaging. We inspected surgery.

We carried out an unannounced focused inspection of BMI The Park Hospital on 30 May 2019, in response to concerning information we had received in relation to the management of the regulated activities at this location.

During this inspection we inspected using our focussed inspection methodology. We inspected the key questions of safe and well-led only. We did not provide an overall or key question rating at this inspection, as we did not carry out a comprehensive inspection.

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? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

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

Our findings were:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff knew how to access systems to allow them to complete their training
  • 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 most infection risks well. The service used systems to identify and prevent surgical site infections. Staff used equipment and control 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 equipment. Staff managed clinical waste well.
  • Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.
  • The service had enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
  • The service had enough medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.
  • The service used systems and processes to safely prescribe, administer, record and store medicines.
  • 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. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.
  • Leaders had the integrity, skills and abilities to run the service. 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 hospital had a vision for what it wanted to achieve and a set of values, to turn it into action. The vision and values were patient focused.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service had an open culture where staff could raise concerns without fear.
  • Leaders operated effective governance processes throughout the service. Staff at all levels were clear about their roles and accountabilities.
  • 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 could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements.
  • Leaders and staff actively and openly engaged with patients and staff 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.

However:

  • Having a carpet in the corridor did not conform with Health Building Note 00-09: Infection control in the built environment.
  • In two treatment rooms, both for clinical use, taps were aligned to run directly into the drain aperture. This meant contamination from the waste outlet could be mobilised and did not conform with Health Building Note 00-10 Part C.
  • We found inconsistences with daily temperature checks and found there was a total of 11 days between 1 March 2019 and 30 May 2019 where there had been no fridge temperature checks.

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

Nigel Acheson

Deputy Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 23 July 2019

Effective

Good

Updated 23 July 2019

Caring

Good

Updated 23 July 2019

Responsive

Good

Updated 23 July 2019

Well-led

Good

Updated 23 July 2019

Checks on specific services

Medical care (including older people’s care)

Good

Updated 10 July 2018

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 surgery section.

We rated this service as good:

  • The service managed staffing effectively and services had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
  • Arrangements to safeguard adults and children from abuse and neglect that reflected relevant legislation and local requirements were in place and staff had received effective training in safeguarding adults and children at a level appropriate for their role.
  • Standards of cleanliness and hygiene were appropriately maintained, there were reliable systems in place to prevent infection and protect people from a healthcare-associated infection. Patient-Led Assessments of the Care Environment’ (PLACE) results were above the England average and local hand hygiene audits showed 100% compliance.
  • Risks to patients were assessed, and their safety monitored and managed so they were supported to stay safe. Staff consistently identified and responded appropriately to changing risks to patients, including for example, the deteriorating patient.
  • The service had a good track record on safety. Staff understood their responsibilities to raise concerns, to record safety incidents, concerns and near misses, incidents were investigated appropriately and lessons learned shared across the hospital services and the wider corporate provider.

Outpatients and diagnostic imaging

Requires improvement

Updated 27 March 2017

We rated this service as requires improvement because:

The hospital depended on bank staff who did not all receive mandatory training, and who were not always available if a child had an appointment at short notice. This posed a risk to patient safety.

The hospital did not have a clear system for allocating sufficient nursing staff to support clinics or for booking clinic rooms.

Equipment checks were not robust to keep people safe. Checks for cardiac monitoring equipment were overdue in diagnostic imaging.

The hospital had not defined its vision for outpatients or for children’s services. Its risk register and risk assessment approach did not include the risks to children, and there were no dedicated areas for children in outpatients.

The services did not use data and performance monitoring to improve quality. Participation in national and clinical audits and benchmarking was poor. There was a lack of formal monitoring of how responsive the service was for outpatients and no quality and performance dashboard reported publicly.

Public engagement and learning from patient comments in outpatients was limited. Although there was a corporate range of informative leaflets, there were no specific leaflets for outpatients who were children, or leaflets in alternative formats.

Staff learnt from safety and quality incidents and shared learning across the hospital, and governance arrangements supported this well. There was an effective process for investigating serious incidents. Staff had a good understanding of safeguarding and how to react to concerns.

The patients we spoke with told us staff were kind, caring and they were likely or extremely likely to recommend the service. Patients received clear information prior to their appointment and were able to ask questions and get clear responses during their appointment. Nurses, doctors and imaging staff obtained consent to care and treatment in line with legislation and guidance.

Staff considered the individualised needs of patients when planning care. Services coordinated appointments to enable patients to see a number of services in one day. Nurses, doctors and imaging staff combined their skills well in a good multidisciplinary team approach to meeting the needs of patients using the service.

The hospital had a clear vision for its imaging services and imaging staff contributed to strategic decisions. Outpatient staff had strong leadership at service level with the ability to problem solve.

Waiting times for outpatient appointments were within the national guidelines Patient care and treatment reflected relevant research and guidance, including the Royal Colleges and National Institute for Health and Care Excellence (NICE) guidance.

Surgery

Good

Updated 23 July 2019

During this inspection we inspected using our focussed inspection methodology. We inspected the key questions of safe and well-led only. We did not provide an overall or key question rating at this inspection, as we did not carry out a comprehensive inspection.