You are here

Spire Liverpool Hospital Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 1 August 2019

Spire Liverpool Hospital is operated by Spire Healthcare Limited. The hospital offers surgery, outpatients and diagnostic imaging services. The hospital provides services for NHS and privately funded patients.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection of Spire Liverpool Hospital between 23 and 25 April 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 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 is the first time we have rated this hospital. We rated it as Good overall.

We found the following areas of good practice:

  • The service had enough staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment. The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff had training on how to recognise and report abuse and they knew how to apply it. Staff completed and updated risk assessments for each patient.
  • The service controlled infection risk well. The service had suitable premises and equipment and looked after them well. The service followed best practice when prescribing, giving, recording and storing medicines.
  • The service had enough nursing, medical, allied health professional and support staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
  • The service provided care and treatment based on national guidance and evidence of its effectiveness to achieve positive outcomes for patients.
  • Managers appraised staff’s work performance and made sure staff were competent for their roles. Doctors, nurses and other healthcare professionals supported each other to provide good care.
  • Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.
  • Staff cared for patients with compassion, dignity and respect. Feedback from patients confirmed staff treated them well and with kindness. Staff involved patients and those close to them in decisions about their care and treatment.
  • The service planned and provided services in a way that met the needs of local people. People could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

  • Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.

  • There was a clear governance structure in place, which all staff we spoke with understood. The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.
  • Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

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

  • Some patient records contained gaps and omissions, such as missing staff and patient signatures and rationale for treatment. This had also been identified by the service’s own records audit processes.
  • We found one patient had received treatment although they were out of the provider’s usual admission / exclusion criteria.  There was no medical record available to record the rationale for the surgery to take place outside of the services policy. 
  • The hospital’s policy for reporting safeguarding incidents was not always followed by staff.
  • Not all staff (such as consultants) directly reported patient safety incidents on the incident reporting system.
  • Clean linen was not always suitably stored. However; the service had ordered new trollies to improve this and were awaiting delivery at the time of our inspection..

  • Changes to the early warning system for monitoring deteriorating patients had not been fully embedded in the surgical 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 areas

Safe

Good

Updated 1 August 2019

This is the first time we have rated this service. We rated it as Good because:

  • The service had enough staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff had training on how to recognise and report abuse and they knew how to apply it. Staff completed and updated risk assessments for each patient.
  • Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection. The service had suitable premises and equipment and looked after them well.
  • The service followed best practice when prescribing, giving, recording and storing medicines. Managers investigated incidents and shared lessons learned with the whole team and the wider service.

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

  • Some patient records contained gaps and omissions, such as missing staff and patient signatures and rationale for treatment. This had also been identified by the service’s own records audit processes.
  • We found one patient had received treatment although they were out of the provider’s usual admission / exclusion criteria.  There was no medical record available to record the rationale for the surgery to take place outside of the services policy. 
  • The hospital’s policy for reporting safeguarding incidents was not always followed by staff.
  • Not all staff (such as consultants) directly reported patient safety incidents on the incident reporting system.
  • Clean linen was not always suitably stored. However; the service had ordered new trollies to improve this and were awaiting delivery at the time of our inspection.

  • Changes to the early warning system for monitoring deteriorating patients had not been fully embedded in the surgical service.

Effective

Good

Updated 1 August 2019

This is the first time we have rated this service. We rated it as Good because:

  • The service provided care and treatment based on national guidance and evidence of its effectiveness to achieve positive outcomes for patients.
  • Accurate and up-to-date information about the effectiveness of care and treatment was shared internally and externally. The information was used to improve outcomes for patients and any improvement plans were checked and monitored.
  • Staff assessed and monitored patients regularly to see if they were in pain and administered appropriate pain relief.
  • Managers appraised staff’s work performance and made sure staff were competent for their roles. Doctors, nurses and other healthcare professionals supported each other to provide good care.
  • Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

Caring

Good

Updated 1 August 2019

This is the first time we have rated this service. We rated it as Good because:

  • Staff responded compassionately when patients or their relatives needed help. Support was given by caring staff as and when required by patients to meet their individual needs.
  • Feedback from patients confirmed staff treated them well and with kindness. Staff provided emotional support to patients to minimise their distress.
  • Staff provided information to patients in a way they could understand. Patients were supported to understand their condition, care, treatment and any advice.

Responsive

Good

Updated 1 August 2019

This is the first time we have rated this service. We rated it as Good because:

  • The service planned and provided care and treatment in a way that met the needs of local people. Facilities and premises were appropriately adapted to meet the individual needs of patients.
  • The service took account of patients’ individual needs.
  • People could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

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

  • The absence of the complaints lead led to a six-month period where complaint responses did not meet the services targets.

Well-led

Good

Updated 1 August 2019

This is the first time we have rated this service. We rated it as Good because:

  • Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.
  • Managers at every level demonstrated shared values that encouraged pride and positivity in the organisation and focussed attention on the needs and experiences of patients.

  • The service had a clear vision and strategy to outline what it wanted to achieve and workable plans to turn it into action. Staff understood the vision and applied it in practice.
  • There was a clear governance structure in place, which all staff we spoke with understood.
  • The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.
  • Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
  • There were systems in place that supported improvement and innovation work.
Checks on specific services

Diagnostic imaging

Good

Updated 1 August 2019

We rated this service as good because it was safe, caring, responsive to people’s needs and well-led. We do not rate effective for diagnostic imaging services.

Outpatients

Good

Updated 1 August 2019

We rated this service as good because it was safe, caring, responsive to people’s needs and well-led. We do not rate effective for outpatient services.

Surgery

Good

Updated 1 August 2019

Surgery was the main activity of the hospital. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section.

We rated this service as good because it was safe, effective, caring, responsive to people’s needs and well-led.