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Spire Clare Park Hospital Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 16 August 2018

Spire Clare Park Hospital is operated by Spire Healthcare Limited. The hospital provides surgery, medical care, out patients and diagnostic imaging services for adults, children and young people. Following national guidance, inpatient surgical services and outpatient physiotherapy services were only offered to children age three and above.

We carried out the inspection on 30 May 2018.This was a focussed (follow up) inspection to assess whether the service had made required improvements to the children and young people’s service, following our previous inspection of the service in August 2016.

We gave the hospital seven days’ notice of the inspection, to ensure staff representatives from the children and young people’s service were available on the day of inspection.

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.

Services we rate

We rated children and young people’s services as good. This was an improvement from the previous rating of requires improvement.

There were systems and processes in place and followed by staff to keep children and young people safe and safeguarded from abuse. There were sufficient numbers of staff with relevant skills and experience and up to date mandatory training in safety systems, processes and practices to deliver safe care to children and young people. Risks to children and young people were assessed and staff acted to reduce identified risks. There was a good track record on safety and staff under stood their responsibilities to raise concerns and incidents.

Children and young people’s care and treatment was delivered in line with current evidence based guidance and standards. The service monitored the effectiveness of care and treatment and used the findings to benchmark against other similar services and improve services. Consent to care and treatment was obtained in line with national guidance

Staff cared for children, young people and their families with compassion. Feedback from patients and their parents was positive about the way staff treated them. The emotional needs of children, young people and their parents were fully considered. There was effective use of distraction activities to reduce anxieties in children and young people. Staff involved children, young people and their parents in decisions about their care and treatment.

The service was planned around meeting the needs of the local population, with appointments and admissions offered to meet the individual circumstances of each patient.

There was clear leadership of the children and young people’s service. A lead nurse had responsibility and accountability for all the children and young people’s services in the hospital. There was identified medical leadership. Governance and risk management processes supported improvements to the service. There was an inclusive culture, with staff of all professions across the hospital working together to deliver quality care to children and young people. There were processes for children, young people and their parents to feedback about their experience of care and treatment at the hospital. Staff acted on this feedback to make improvements to the service.

However, we found that although the quality of inpatient and some outpatient records were monitored, there was no process to audit the quality and content of outpatient records held solely by consultants and not shared with the hospital.

Staff took account of the distress carrying out observations may have on children. However, when they did not carry out formal observations to reduce children’s distress, they did not always record this reason. Staff did not record the informal visual observations that they carried out to determine the child’s condition was stable and the child was not at risk of deterioration.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

We rated children and young people’s services as good. This was an improvement from the previous rating of requires improvement.

Inspection areas

Safe

Good

Updated 16 August 2018

Effective

Good

Updated 16 August 2018

Caring

Good

Updated 16 August 2018

Responsive

Good

Updated 16 August 2018

Well-led

Good

Updated 16 August 2018

Checks on specific services

Services for children & young people

Good

Updated 16 August 2018

Children and young people’s services were a small proportion of hospital activity.

We rated this service as good because it was safe, effective, caring, responsive and well led.

Outpatients and diagnostic imaging

Good

Updated 22 February 2017

We rated this service as good overall. We found outpatients and diagnostic imaging was good for the key questions of safe, caring, responsive and well led. We did not rate effective, as we do not currently collate sufficient evidence to enable a rating.

There were appropriate systems in place to keep patients safe. Staff fulfilled their responsibilities to raise concerns and report incidents and near misses. Patients were appropriately safeguarded from abuse and avoidable harm. Staff undertook appropriate mandatory training for their role and they protected patients from the risk of abuse and avoidable harm. The hospital was generally clean and tidy but we found areas of dust in a number of consulting rooms. Cleaning schedules were not displayed in all outpatient areas. Staff wore protective clothing and followed hand hygiene procedures to reduce the spread of infection.

Care and treatment was delivered in line with current evidence based guidance, and best practice and legislation. There was evidence of local and national audits, including clinical audits. Staff were qualified and had the appropriate skills to carry out their roles effectively. Managers supported staff to deliver effective care and treatment, through meaningful and timely appraisal.

We observed that staff were caring, kind, compassionate, and treated patients with dignity and respect. Feedback from people who used the service and those close to them was positive about the way staff treated them.

There was good availability of appointments for patients across all specialities. Access to appointments was timely; staff held clinics on weekdays into the evening and on Saturdays to suit patients’ preferences. Waiting times, delays, and cancellations were minimal and managed appropriately.

Translation services were available when required and staff made practical adjustments to accommodate patients’ individual needs, for example, when caring for patients with dementia. Complaints were taken seriously, investigated thoroughly and resulted in positive changes made to practice and procedures.

Effective governance and risk management systems were in place. Local and senior managers were visible and approachable to all staff. There was an open and supportive learning culture. Staff gave patients opportunities to provide feedback about their experiences and they used the feedback to improve the service.

Surgery

Good

Updated 22 February 2017

Overall, we rated surgical services as good for safe, effective, caring, responsive and well led care. Openness and transparency about safety was encouraged. Incidents were reported and investigated and learning was shared widely to prevent similar reoccurrences.

   

Staffing levels and skill mix were planned, implemented and reviewed to keep people safe at all times. Staff were appropriately qualified and had the skills to carry out their roles effectively.

  

Peoples care and treatment was planned and took account of current evidence based practice, standards, best practice and legislation.

Feedback from patients about their care and treatment was always positive. We observed patients were treated with kindness, compassion and dignity though out our visit.

There was variability in the full completion of the ‘five steps to safer surgery’ checklist, and all aspects of the administration of controlled drug medication. The service was taking actions to improve the variability.

Services were planned in a way that met the needs of the local population. The importance of flexibility and choice was reflected in the service and there were ongoing plans for further development. The hospital had not met national referral to treatment time indicator from January 2016 to July 2016 due to staff vacancy. Following a successful appointment, the hospital in August 2016 was back on track with the indicator.

Complaints and concerns were taken seriously, responded to in a timely way and improvements were made to the quality of care as a result.

The leadership actively shaped the culture through effective engagement with staff, people who use services and their representatives, and other stakeholders.

There was a clear governance framework to monitor quality, performance and risk at department, hospital and corporate level. Staff told us they were aware of the risks, and action taken to mitigate these risks for their individual departments.