Spire Parkway Hospital

We carried out this inspection because the service had not been inspected since 2019.

Spire Parkway hospital is part of Spire Healthcare limited. The hospital is a private hospital and is registered for the regulated activities of treatment of disease, disorder or injury; diagnostic and screening procedures; surgical procedures; management of supply of blood and blood derived products and family planning to adults and children.

Services were provided to patients who were self-funding, those covered by private medical insurance and to NHS patients who had been referred by their GP or who had booked via the NHS “choose and book” service. In the imaging department, the mix of patients between NHS and private was around half and half.

During our inspection we spoke to 11 members of staff including hospitals leaders, radiographers, and administrators. We spoke to 4 patients and looked at 8 sets of records of patients scanned during our visit.

We reviewed care records, policies, and other documentation relevant to the service.

We assessed all quality statements across the safe, effective, caring, responsive, and well-led key questions and have combined the scores for these areas to give an overall rating. We rated the service as good overall.

The imaging department had a computerised tomography (CT) scanner; a magnetic resonance imaging (MRI) scanner; general, fluoroscopy, mammography, and mobile x-ray sets; and 2 ultrasound scanners.

We carried out this assessment as the service had not been inspected since 2019.

Spire Parkway Hospital is part of the Spire Healthcare Limited. The hospital is a private hospital and offers the following services, treatment of disease, disorder or injury, diagnostic and screening procedures, surgical procedures, management of supply of blood and blood derived products and family planning to adults and children.

The cancer centre is a stand alone unit within the grounds of the hospital. It is open Monday to Friday 8 a.m. to 6 p.m. The endoscopy service ran on a Monday, Tuesday and Friday.

Services were provided to patients who were self-funding and those covered by private medical insurance.

During our inspection we spoke with 15 staff including hospital leaders, endoscopy staff, clinical nurse specialists, medical staff including a haematology consultant, cancer centre staff, chemotherapy nurses, pharmacy staff, administration staff and housekeepers.

We assessed all quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas to give an overall rating. We rated the service as good overall.

Safe:

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

At our last inspection we rated this key question as good. At this inspection the rating has remained good. This meant patients are protected from avoidable harm.

Effective:

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff had training in mental capacity and undertook assessments when needed, involving those who were important to people and ensuring decisions in people’s best interests.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant the service provided effective care.

Caring:

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

At our last inspection we rated this key question as outstanding. At this inspection we have rated it as good. This meant staff treat patients with kindness, compassion, dignity and respect.

Responsive:

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant services met people’s changing individual needs.

Well-led:

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. There was a culture of continuous improvement with staff given time and resources to try new ideas.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant the service was well led with good governance

We carried out this assessment as the service had not been inspected since 2019.

Spire Parkway Hospital is part of the Spire Healthcare Limited. The hospital is a private hospital and offers the following services, treatment of disease, disorder or injury, diagnostic and screening procedures, surgical procedures, management of supply of blood and blood derived products and family planning to adults and children.

Services were provided to patients who were self-funding, those covered by private medical insurance and to NHS patients who had been referred by their GP or who had booked via the NHS “choose and book” service.

The outpatient’s department had 14 consultation rooms in 2 separate areas, with 2 waiting rooms, 2 treatment rooms and 1 reception desk. The physiotherapy department had a reception desk, waiting area, 7 treatment rooms and a gym.

During our inspection we spoke with 16 staff including hospital leaders, outpatient nurses, consultants, physiotherapy staff, pharmacy staff and administration staff.

We reviewed care records, policies, and other documentation relevant to the service.

We assessed all quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas to give an overall rating. The outpatient department rated good overall, demonstrating strong performance across most areas.

Safe:

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Effective:

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those who were important to people and took decisions in people’s best interests where they did not have capacity.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Caring:

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Responsive:

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

At our last inspection we rated this key question as outstanding. At this inspection the rating was good. This meant patients were safe and protected from avoidable harm.

Well-led:

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. There was a culture of continuous improvement with staff given time and resources to try new ideas.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Spire Parkway Hospital offered services to children age 0 to 18 years of age. Only children over the age of 3 years old were accepted for surgical day treatment, the outpatients’ teams saw children under 3 years of age. Services for children and young people (CYP) included several surgical procedures; oral and maxillofacial surgery for wisdom tooth extraction, ear pinning and meniscal repair surgery for tears of the knee cartilage. The service also provided physiotherapy, diagnostic imaging, screening services, and selected urology procedures for children and young people. The service did not complete the same volume of procedures for children and young people as it did for adults. Children and young people were accompanied to surgery, outpatients and diagnostic imaging appointments by their parents or an appropriate adult over the age of 18. Children and young people services appointments were offered 1 or 2 days each week depending on demand, and some Saturdays.

Services were provided to children and young people whose treatment was being self-funded or covered by private medical insurance and to NHS patients who had been referred by their GP or who had booked via the NHS “choose and book” service.

During our inspection we spoke with 10 staff including hospital leaders, the children and young people lead, ward and theatre staff, preoperative assessment staff, pharmacy staff, administration staff and housekeepers. We spoke to staff from all areas where children and young people would be seen including outpatients, physiotherapy and diagnostic imaging and surgery.

Inspectors from the CQC medicines team also attended the inspection. They spoke with nurses and pharmacists in this area. We inspected medicine storage areas and reviewed 3 medicine charts. We looked at relevant medicines policies.

We assessed all quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas to give an overall rating. We rated the service as good overall.

We carried out this assessment as the service had not been inspected since 2019.

Spire Parkway Hospital is part of the Spire Healthcare Limited. The hospital is a private hospital and offers the following services, treatment of disease, disorder or injury, diagnostic and screening procedures, surgical procedures, management of supply of blood and blood derived products and family planning to adults and children.

Services were provided to patients who were self-funding, those covered by private medical insurance and to NHS patients who had been referred by their GP or who had booked via the NHS “choose and book” service.

During our inspection we spoke with 35 staff including hospital leaders, ward staff theatre staff, preoperative assessment staff, pharmacy staff, administration staff and housekeepers.

We assessed all quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas to give an overall rating. We rated the service as good overall.

However, the service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. This was a breach of Regulation 17 (1)(a), good governance. Processes to manage medication were not always in place. Record keeping for controlled drugs (CDs) was not always done in line with national guidance, which meant that corrections could not be read clearly. Paper private prescriptions were used on the wards, but record keeping was not consistent with other areas of the hospital, and this meant that some private prescriptions could not be accounted for.

Allergy sensitivity was not always recorded, and vital details were missed on a medication history that we reviewed. Medicines were not always prescribed on paper charts according to local guidance. ‘When required’ medicines were not always prescribed completely, often missing indications and maximum doses. Audits on medicines handling did not identify issues found on this inspection.

Safe:

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. However, staff did not always manage medicines well and involved people in planning any changes.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Effective:

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those who were important to people and took decisions in people’s best interests where they did not have capacity.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Caring:

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

At our last inspection we rated this key question as outstanding. At this inspection we have rated it as good. This meant patients were safe and protected from avoidable harm.

Responsive:

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.

Well-led:

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. There was a culture of continuous improvement with staff given time and resources to try new ideas.

However, the service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. This was a breach of Regulation 17 (1)(a), good governance. Processes to manage medication were not always in place. Record keeping for controlled drugs (CDs) was not always done in line with national guidance, which meant that corrections could not be read clearly. Paper private prescriptions used on the wards, but record keeping was not consistent with other areas of the hospital, and this meant that some private prescriptions could not be accounted for.

Allergy sensitivity was not always recorded, and vital details were missed on a medication history that we reviewed. Medicines were not always prescribed on paper charts according to local guidance. ‘When required’ medicines were not always prescribed completely, often missing indications and maximum doses. Audits on medicines handling did not identify issues found on this inspection.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. This meant patients were safe and protected from avoidable harm.