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Spire Washington Hospital Good


Inspection carried out on 4 December 2019 to 5 December 2019 and 7 February 2020

During a routine inspection

Spire Washington Hospital is operated by Spire Healthcare Limited. The hospital had 47 beds, however the hospital provided information stating there were currently 36 beds operational.

The hospital provides a range of inpatient and outpatient elective services. We inspected surgery, termination of pregnancy, outpatients and diagnostic imaging.

We carried out the unannounced visit to the hospital on 4 and 5 December 2019 and inspected the diagnostic imaging service on the 7 February 2020.

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.

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 level.

Services we rate

Our rating of this hospital stayed the same. We rated it as Good overall.

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff understood how to protect patients from abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The service controlled infection risk well. 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 managed clinical waste well.

  • Staff identified and acted upon patients at risk of deterioration. The service had enough staff with the right qualifications, skills, training and experience. Managers regularly reviewed and adjusted staffing levels.

  • 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.

  • The service provided care and treatment based on national guidance and evidence-based practice. The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.

  • Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care. Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff provided emotional support to patients, families and carers to minimise their distress. Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.

  • The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care.

  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.

  • People could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with national standards.

  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff.

  • Leaders understood and managed the priorities and issues the service faced. 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 service had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy. Leaders and staff understood and knew how to apply them and monitor progress.

  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.

  • The service collected reliable data and analysed it. 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, staff, and local organisations to plan and manage services. All staff were committed to continually learning and improving services.

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

  • Staff did not always keep detailed records of patients’ care and treatment in the outpatient department.

  • We observed some inconsistencies in executing the WHO checklist which was not implemented consistently across each operating theatre.

  • Recruitment and retention of orthopaedic scrub staff for theatres required some development to alleviate shortages.

  • Some items of equipment were overdue for service which did not comply with documentation.

  • Staff used personal protective equipment with one exception we observed following which immediate action was taken to remedy practice.

  • Some key positions were filled on an interim basis and the hospital identified recruitment to key leadership roles in clinical areas as an area for development.

  • Consultation appointments were available on only one weekday in the termination of pregnancy service.

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

Ann Ford

Deputy Chief Inspector of Hospitals (North Region)

Inspection carried out on 5-6 and 18 August 2015

During a routine inspection

Inspection carried out on 12 November 2013

During a routine inspection

All of the patients we spoke with were happy with their care and treatment. One patient said �I can only describe the care as outstanding�. Another said �I couldn�t rate the hospital highly enough, and I have been well looked after, the staff are professional and caring.� A patient also told us �Everything was explained properly and the girls (nurses) are smashing�. We talked with some of the in-patients and their relatives, and found that people spoke positively about their experiences of care and treatment at the hospital. We found people were asked to sign a consent form before receiving any treatment. The people we spoke with said they had received an assessment of their needs and felt supported by all members of the staff team.

We looked at staff rotas for in patient and other departments operating throughout the hospital and found they were being adequately staffed. We saw that the provider had a system in place for the quality checking of systems to manage risks and assure the health welfare and safety of people. The provider also responded to any complaints they received. Complaints were monitored so that the provider could learn from mistakes and improve the service.

Inspection carried out on 28 November 2012

During a routine inspection

We spoke to five people from both the inpatient unit and the outpatients department. People told us the care was �excellent�, �very good� and they �couldn�t fault the care they received. One person told us �They treat me like I am someone special�. We were told by people we spoke to that they had completed a pre operation questionnaire prior to admission to the hospital. They also attended a pre operation assessment and were told by the consultant what to expect prior to their admission to hospital. The people in the outpatients department we spoke to had all attended the hospital for several appointments over a period of months and were all pleased with the service they received. One person told us the doctor asked for their opinion and explained the procedure they were to have thoroughly and put them at their ease.

Inspection carried out on 22 March 2012

During a themed inspection looking at Termination of Pregnancy Services

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.

Inspection carried out on 16 January 2012

During a routine inspection

During our visit we spoke with people on the day care unit, out-patients department and people who had been admitted to the hospital ward. The overwhelming majority of views from people using the service, about the care they had received, were very positive.

Comments from people included, �It�s great, fantastic, could not be better� and, �Staff are fine, everybody has been really nice�.

Reports under our old system of regulation (including those from before CQC was created)