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Spire Fylde Coast Hospital Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 2 September 2019

Spire Fylde Coast Hospital is operated by Spire Healthcare Ltd. It is a private hospital in Blackpool, Lancashire. The hospital has been operating for over 35 years (opening in 1983). It is located 400 yards from a local NHS trust main acute site. It is on the outskirts of the town of Blackpool and about one mile from the seaside promenade. Blackpool and the wider Fylde Coast have a population of around 350,000. The hospital primarily serves the communities of Blackpool and the Fylde Coast, however it also accepts patient referrals from outside this area.

The hospital is registered to provide diagnostic and screening procedures, surgical procedures and treatment of disease, disorder and injury. The hospital has 26 single rooms and 11 day-care beds which are provided in two single sex bays. Facilities include three operating theatres, 10 consulting rooms, physiotherapy treatment rooms, medical imaging services and outpatient and diagnostic facilities. Outpatient clinics are also provided from a small clinic in Lytham, approximately 20 minutes away. Facilities for plain x-ray diagnostic tests are also available in this clinic.

The hospital has a registered manager who has worked in a managerial post at the hospital since September 2015, working alongside the previous registered manager. The registered manager was appointed in August 2016.

Inspection areas

Safe

Good

Updated 2 September 2019

Our rating of safe improved. We rated it as Good because:

  • Staff had training in key skills and this was provided through a mixture of face to face and electronic training sessions, which were to be completed annually or biennially.

  • Staff understood how to protect patients from abuse and had training on how to recognise and report abuse.

  • The service controlled infection risk well. There was a patient and visitor information board that included information about infection prevention and control.

  • The service had suitable premises and equipment and looked after them well.

  • They managed medicines well. The service followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right time.

  • The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.

  • The service had enough staff to care for patients and keep them safe.

  • Staff collected safety information and used it to improve the service.

However:

  • We found that safeguarding concerns were not always documented in line with the hospital policy.

  • We were given an example of a safeguarding concern which had been raised in the imaging department by a member of staff. Radiography staff followed the hospitals policy in respect of escalation to the safeguarding lead for the hospital. Appropriate action was taken internally to follow up the concern. However, we did not see documented evidence of this and an incident report form had not been completed in accordance with the hospital policy. This meant that if there were future concerns there was no documented evidence of the concerns and action that had been taken on that occasion.

  • The provider should consider providing refresher training to staff around emergency resuscitation equipment so that they are able to carry out checks on equipment effectively.

  • Not all staff were aware of their roles and responsibilities under duty of candour which is the process of being open and honest when things go wrong.

  • We found that although the provider had a process for regularly checking expiry dates on consumables, stored as part of emergency resuscitation equipment, we found one item on an emergency resuscitation trolley to be out of date, which had been highlighted but not removed.

Effective

Good

Updated 2 September 2019

Our rating of effective improved. We rated it as Good because:

  • The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.

  • Managers used the Spire Healthcare scorecards to benchmark performance against other hospitals within the provider group. The scorecard monitored key performance indicators such as returns to theatre, surgical site infections, transfers to hospital, readmission rates and incidence of blood clots.

  • Staff ensured that patients received enough food and drink to meet their needs and improve their health. The patient waiting area contained a water cooler and there were cups available for patients and their carers or relatives to use. Patients could also use hot drinking making facilities which were available in the main entrance.

  • Staff regularly assessed patient’s pain using pain scores and we saw that this was documented in patient records at each assessment.

  • Intentional rounding was also used as a tool to prompt staff to ask about patient’s levels of pain and ask if they needed any pain relief.

  • Patient outcome performance was monitored by the clinical audit and effectiveness committee, clinical governance committee and medical advisory committee. There were action plans in place for any measure which fell below Spire targets.

  • Staff received appraisals which took into account their individual performance, training needs and career aspirations. These were referred to as ‘enabling excellence’ meetings.

  • Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care. The service worked closely with surrounding hospitals.

  • The hospital provided some seven-day services.

  • Staff understood the consent process and they followed the service policy and procedures when a patient could not give consent. They understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005. They knew how to support patients experiencing mental ill health and those who lacked the capacity to make decisions about their care.

However:

  • We found that the provider needed to consider how to improve access to evidence that staff employed as surgical first assistants have the appropriate qualifications and professional requirements in place when required. The provider should keep online and paper records relating to policies up to date if paper records are to be used.

Caring

Good

Updated 2 September 2019

Our rating of caring stayed the same. We rated it as Good because:

  • Staff provided emotional support to patients when they needed it and provided reassurance.

  • We observed that patients were treated with privacy and dignity.

  • Patient feedback about their care and treatment was very positive.

  • Staff involved patients and those close to them in decisions about their care and treatment.

  • We observed that patients and their carers were involved in discussions about the patient’s treatment.

Responsive

Good

Updated 2 September 2019

Our rating of responsive stayed the same. We rated it as Good because:

  • The service planned and provided services in a way that met the needs of people who used the service.

  • The service took account of patients’ individual needs. Systems were in place to support those people with additional requirements.

  • 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.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

  • The hospital provides free of charge Echo cardiograms for all patients who require this test as part of a surgical care pathway. This ensures patients have access to timely treatment as required

However:

  • We found that within the diagnostic imaging service, documented evidence of complaints were not always in line with the hospitals policy.

Well-led

Good

Updated 2 September 2019

Our rating of well-led improved. We rated it as Good because:

  • The hospital had gone through recent changes within the senior management team which included the recruitment of a theatre manager and deputy matron who had the right skills and experience to provide strong leadership.

  • There was a vision and strategy for the hospital which focussed around patient safety and commercial viability.

  • At the time of our inspection, the hospital strategy was to; ‘deliver high quality care to our patients, demonstrating that we are the provider of choice for the Fylde Coast, growing our relationships with our partners to increase our market share by promoting our clinical services to the local population, continue to improve the hospital’s survey scores by promoting the benefits of teamwork, improving communication between us all and continuing to build on what we do well and work together to deliver on our promises’.

  • Staff we spoke to throughout the service reported a supportive and open culture. We were told by staff working in theatres that there was no divide between staff members of different roles such as nurses and operating department practitioners.

  • There were effective structures, processes and systems of accountability to support the delivery of good quality, sustainable services.

  • The Spire Healthcare governance framework was implemented at Spire Fylde Coast Hospital to support oversight and management of risk and performance issues.

  • There was a risk register in place for the hospital which included risks for each department. . For surgical services, the highest rated risk was that the operating table in theatre three needed replacing. There were appropriate actions in place to mitigate this risk until a new table was resourced.

  • The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards. The information used in reporting performance management and delivering quality care was consistently found to be accurate, valid, reliable, timely and relevant.

  • Senior leaders engaged well with staff and patients to shape and improve service provision.

  • The service was committed to learning from when things went wrong and strived for continuous improvement.

  • The service produced 48-hour flash reports to share best practice to encourage improvement. The 48-hour flash reports were shared throughout every hospital within the group. Each hospital had to acknowledge it had read and distributed the report to the local teams.

However:

  • The new leadership structure did not provide defined roles and lines of responsibility.
  • The hospital strategy was published annually and although managers and staff we spoke to were aware of the strategy, some told us that they had not always been consulted on it.

  • The diagnostic imaging service should consider a review of its engagement with staff, patients and service users to capture their views to improve the quality of services provided.
Checks on specific services

Surgery

Good

Updated 2 September 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 and well-led. The service had made improvements to safety processes and governance systems since our last inspection.

Staff had the right skills and qualifications to carry out their roles safely and effectively. A staffing tool was used to calculate staffing needs based on the acuity of patients listed for surgery.

Managers monitored service performance using feedback from patients, key performance indicators and patient outcome data. This information was compared with similar providers where possible.

Patient feedback was largely positive. We observed staff taking the time to interact with patients and staff spoke about patients and their relatives with respect and compassion.

Care was provided taking into account the needs of individuals and people could access care and treatment when they needed it.

There were effective leaders employed within the service. Staff spoke positively about the senior leadership team. Senior managers had made efforts to encourage continuous learning and there had been positive changes to the culture within the service.

Diagnostic imaging

Good

Updated 2 September 2019

We rated this service as good because it was safe, caring, responsive and well-led. We inspected but did not rate effective.

There were onsite X-ray, mammography and ultrasound facilities. Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans were provided by Spires Mobile Unit. The service was available six days a week, and evening appointments were available. Outside of normal working hours there was an on-call service provided.

Staff had received mandatory training and were aware of their responsibilities to safeguard patients from abuse. The environment was visibly clean and tidy, and equipment was well maintained.

Care and treatment was based on national guidance and they monitored the effectiveness of this. The service made sure that staff were competent to undertake their roles and there was evidence of multidisciplinary team working.

Feedback from patients was positive about their care and we observed caring interactions between staff and patients.

The service met the needs of patients and took into account their individual needs. Patients could access the service when they needed it and complaints were low.

There was a positive culture and staff felt that the leadership team was approachable. Risks were managed well and staff were encouraged to learn and develop.

Outpatients

Good

Updated 2 September 2019

We rated this service as good because it was safe,

caring, responsive and well-led.

We inspected but did not rate effective.

The service saw only adults and was available six days a week with clinics available in the evenings. Staff had received mandatory training and safeguarding training. There had been no infections in the department and all areas were visibly clean and tidy. Staff worked to national guidelines and there was evidence of multi-disciplinary team working amongst different staff groups. Staff were caring towards patients and there was positive feedback from patients about the staff.

Adjustments were made for patients as necessary and there were few complaints about the service. Staff worked to improve outcomes for patients and monitored these. Leadership was positive and staff said that they liked working at the hospital.