3 September 2021
Mildmay Mission Hospital is a voluntary charitable hospital and rehabilitation unit based in Shoreditch, East London. It is a tertiary healthcare provider of specialist care and rehabilitation for people living with complex HIV-related conditions, particularly HIV associated neuro-cognitive disorder (HAND), also known as HIV-related neuro-cognitive impairment (HNCI) or AIDS dementia. It is Europe’s only centre dedicated to the rehabilitation of people living with HIV related brain injuries.
The hospital is an independent organisation, which provides services to NHS patients from 20 London clinical commissioning groups (CCGs) as well as CCGs and local authorities in other parts of the UK. Mildmay Mission Hospital is registered with the Care Quality Commission to deliver two regulated activities: treatment of disease, disorder or injury and diagnostic and screening procedures. The service has a registered manager.
In March 2020, the hospital opened two new patient pathways in response to the COVID19 global pandemic. The step-down homeless medical care pathway provides step-down care for the homeless population of London, meeting unmet need for specialist medical care following treatment in an acute hospital setting. The step-down COVID-care pathway provides COVID-care beds for people who are homeless.
The hospital formerly provided day services, which were closed due to COVID-19 and were not operating at the time of our visit. There are two inpatient wards: William and Catherine. William Ward has capacity for 14 patients with nine occupied at the time of our visit and Catherine has capacity for 12 patients with 11 beds occupied at the time of the inspection. Wards are mixed gender. Facilities for patients include a gymnasium, occupational therapy rehabilitation room, digital inclusion IT suite, garden room and a chapel with multipurpose faith room.
Mildmay Mission Hospital was last inspected in 2017 and was rated outstanding.
3 September 2021
Our rating of this location went down. We rated it as good because:
- The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse.
- The service was visibly clean and well maintained. Staff managed infection risk well.
- The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
- Staff assessed risks to patients and acted on them. They provided effective care and treatment, gave patients enough to eat and drink, and offered pain relief when patients needed it.
- Staff worked well together for the benefit of patients, supported them to make decisions about their care and provided information to enable them to lead healthier lives. They were focused on the needs of patients receiving care.
- Staff treated patients with compassion and kindness and respected their privacy and dignity. Staff provided emotional support to patients, families and carers.
- The service planned care to meet the needs of local people. People could access the service when they needed it and did not have to wait too long for treatment.
- Leaders ran services well using reliable information systems. Staff felt respected, supported and valued. The service engaged well with patients and the community and all staff were committed to continually improving services.
- The service used both paper and electronic records and information was not always easy to find in patient care records. This meant staff unfamiliar with the system might not be able to find information about patients’ needs promptly.
- Patient risk assessments were not always completed within 48 hours of admission.
- There was an inconsistent approach to care planning. We found a few gaps where patient needs were identified but there was no care plan or insufficient detail. Most care plans did not show evidence of patient involvement.
- Staff did not keep written records of the multidisciplinary team meetings. This increased the risk of important information being lost.