Spire Cambridge Lea Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients told us they had taken part in a pre-operative assessment, prior to admission to the service. The pre-operative assessment process identified key risks and allowed staff to assess each person’s individual needs and preferences.

The service had a clear inclusion and exclusion criteria to determine who could be treated safely at the hospital. As part of the pre-operative assessment process, people with certain medical conditions were excluded from receiving treatment at the hospital. This meant most people treated at the hospital were considered to be “low risk”.

Staff shared key information to keep patients safe when handing over their care to others. Handovers included all necessary key information to keep patients safe.

Staff assessed patients’ pain and used recognised tools to do so. Staff gave pain relief in line with individual needs and best practice and assessed how effective this was. Patients’ pain was addressed before they left the operating theatre.

Patients told us they received pain relief soon after requesting it. They felt their pain was well managed.

Staff completed individual risk assessments and put care plans in place where risks were identified. Records showed staff routinely reviewed risk assessments and care plans.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. All policies we looked at included clear creation and review dates, and referenced current national guidelines. We also saw notice boards displaying up to date guidance for staff.

We reviewed 5 care records to assess the f completion of care plans and risk assessments and found staff had fully completed all 5 records.

Staff fully and accurately completed patients’ fluid and nutrition charts where needed. The information was used to inform care planning and delivery.

Staff ensured patients awaiting surgery were not left nil by mouth for longer than necessary. The service had a “Sip to Send” process, which allowed patients to sip clear fluids up to the planned time of surgery to maintain hydration.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Doctors, nurses, and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

Staff reported healthy working relations across staff groups, including between medical and nursing teams. We saw and heard examples of effective team working which was based on mutual respect and trust.

Staff planned for discharges with consideration people’s individual needs, personal circumstances, ongoing care arrangements and expected outcomes. They started discharge planning at an early stage to ensure it was safe and appropriate for each person’s needs.

Staff held regular and effective multidisciplinary team (MDT) meetings when required to discuss individual patients’ treatment options and improve the care provided.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Patients undergoing elective operations had access to information about their condition, planned treatment and how best to prepare for surgery. Staff discussed with patients about how to optimise their recovery after surgery and how lifestyle choices could support better health outcomes.

Staff told us they provided patients with advice on how to refer or gain access to external NHS services when required, such as for counselling, smoking cessation or alcohol liaison services.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service submitted data to national registries, including the National Joint Registry (NJR), British Spine Registry (BSR) and the Private Healthcare Information Network (PHIN) as well as collecting Patient Reported Outcome Measures (PROMs) to monitor patient outcomes. Staff reviewed this data at appropriate meetings within the service to implement improvement plans where required.

Data showed us surgical site infection rate for joint replacement surgery was less than 0.3% for the previous 12 months, which was in line with national benchmarking.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gained patients’ consent for care and treatment wherever possible, in line with legislation and guidance. The most appropriate doctor sought consent for surgery and discussed the benefits, potential complications, risks and alternative treatment options. Staff checked patients’ at several stages, including before they went to the operating room and immediately prior to surgery.

Patients told us they were involved in decisions about their care and treatment. They were able to describe the risks and benefits staff had discussed with them before tsurgery.

The service completed consent audits. Audit data showed staff completed 95% of surgical consent documentation in line with policy, which met the service target of 95%.

We observed staff seeking verbal consent before providing care or treatment. Staff involved patients in decision making at all levels.

Staff told us they used interpreters to support patients to give informed consent when required, including for British Sign Language interpreters and face to face interpreting services.