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Inspection Summary


Overall summary & rating

Good

Updated 12 July 2019

Sheffield Orthopaedics Limited is an independent healthcare provider specialising in the provision of orthopaedic surgery. They provide surgical services for both NHS and non-NHS patients with services and facilities provided by Claremont Private Hospital Sheffield. The relationship between Sheffield Orthopaedics and the host hospital is governed by contractual agreements.

The service provides consultant care and surgery for primarily adult patients but a small number of young people between the age of 16 and 18 years are also able to access the service.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced visit to the hospital on 11 February 2019.

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 service 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.

Services we rate

This was the first time we had inspected this service. We rated the service as Good overall.

  • There were no serious patient safety incidents reported in relation to the service between August 2017 and July 2018. We were assured that there were policies in place to manage incidents

  • Policies and procedures were in place. The host hospital provided policies relating to medicines management, infection control and the maintenance of the environment and equipment. There was effective sharing of information between the two organisations.

  • 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 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.

  • Care was planned and delivered in line with national evidence based guidance. Patient outcomes were measured and were used to facilitate learning and development.

  • Suitably trained and competent staff delivered care and treatment and there was clear evidence of effective multidisciplinary team working.

  • Patients gave positive feedback about the care and treatment they had received.

  • Patients had timely access to treatment and most were seen within 18 weeks.

  • The service had a clearly defined vision and set of values. Key risks to the service were recorded and managed appropriately.

  • The service had a contract with the host hospital and this was regularly reviewed. Staff had built effective relationships with the host trust and there was evidence of effective communication and information sharing.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)

Inspection areas

Safe

Good

Updated 12 July 2019

This was the first time we had inspected this service. We rated it as Good because:

  • There had been no reported serious incidents between August 2017 and July 2018. Sheffield Orthopaedics Limited had a shared agreement with the host hospital to report incidents collectively and any reported incidents were shared with the host hospital.

  • There were no reported cases of MRSA, MSSA, Clostridium Difficile (C.Difficile) or E.coli from August 2017 to July 2018.

  • Staff followed the host hospital’s infection prevention and control policies. Patients were cared for in visibly clean environments.

  • The service had a shared agreement with the host hospital to ensure any safeguarding issues were addressed. The service followed the host hospital safeguarding policy and any safeguarding issues were addressed jointly. All staff were aware of their responsibilities and had received appropriate training.

  • Appropriate risk assessments were undertaken, and arrangements were in place for the care of the deteriorating patient. World Health Organisation (WHO) checklists were completed appropriately.

Effective

Good

Updated 12 July 2019

This was the first time we had inspected this service. We rated it as Good because:

  • Patients received care according to national guidelines such as the National Institute for Health and Clinical Excellence (NICE) and utilising guidance from the appropriate Royal Colleges. Effective care and treatment were provided using standardised patient care pathways

  • Suitably trained and competent staff who worked well as part of a multi-disciplinary team provided care and treatment.

  • Patient outcomes were measured through patient satisfaction surveys and participation in national programmes such Patient Reported Outcome Measures (PROMS). The service achieved high standards which was used to facilitate learning and development.

    However:

  • Although the service had a local audit programme we did not see evidence of local audit outcomes or examples of learning. We were told that action plans were being developed which would utilise the results to facilitate learning and practice improvement.

Caring

Updated 12 July 2019

Responsive

Good

Updated 12 July 2019

This was the first time we had inspected this service. We rated responsive as Good because:

  • Services were planned to meet the needs of patients. There were a wide range of orthopaedic specialists available who were able to offer a comprehensive musculo-skeletal service. Specialist surgeons were employed under the practising privileges system to provide this service.

  • Most patients received treatment within 18 weeks of referral.

  • The service made appropriate arrangements to meet people’s individual needs such as interpretation.

  • Complaints were dealt with appropriately and patients knew how to make a complaint.

Well-led

Good

Updated 12 July 2019

This was the first time we had inspected this service. We rated well-led as Good because:

  • The service had a clear vision and values which was embedded within the service.

  • Senior management, clinical governance and medical advisory committee (MAC) meetings took place regularly.

  • There was good communication between the service and the host hospital with clear information sharing.

  • Risks were identified and managed appropriately.

Checks on specific services

Outpatients

Good

Updated 12 July 2019

We rated this service as good because it was safe, responsive and well led. We inspected but did not rate caring due to the limited examples we were able to observe due to low activity levels at the time of inspection.

We do not rate effective in this core service.

Surgery

Good

Updated 12 July 2019

Surgery was the main activity of the hospital.

We rated this service as good because it was safe, effective, responsive and well-led. We inspected but did not rate caring due to the limited examples we were able to observe due to low activity levels at the time of inspection.