You are here

Spire Manchester Hospital Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 24 June 2019

Spire Manchester Hospital is operated by Spire Healthcare Limited. It is a new purpose built private hospital, registered by the CQC on 22 January 2017. The hospital has 37 inpatient rooms, a dedicated six bedded paediatric suite, 27-day case rooms and five critical care beds.

The hospital provides surgery, medical care, critical care, services for children and young people, outpatients and diagnostic imaging. Patients are admitted electively, there are no emergency admissions received at the hospital.

The last inspection of this provider was carried out in September 2016 where it was rated as requires improvement. Since that inspection all services have been relocated to a new hospital site in 2017, as a new registration, therefore we have not compared the previous ratings from 2016. We inspected all core services during this inspection.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced visit to the hospital on 5 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 hospital 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 level.

Services we rate

We rated the hospital as Outstanding overall.

  • Staff worked especially hard to make the patient experience as pleasant as possible. Staff recognised and responded to the holistic needs of their patients from the first referral before admission to checks on their wellbeing after they were discharged from the hospital.

  • There was a strong, visible person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity. Relationships between people who use the service, those close to them and staff were strong, caring, respectful and supportive. These relationships were highly valued by staff and promoted by leaders. The hospital always looked after its equipment and premises. The hospital controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.

  • Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.

  • The hospital planned and provided services in a way that met the needs of local people. It put peoples’ needs central to the delivery of tailored services.

  • Opportunities to participate in benchmarking and peer review were proactively pursued, including participation in approved accreditation schemes.

  • The hospital had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

  • Staff, teams and services were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care to people who used services. For example, patients having complex spinal surgery would have a dry run to help the theatre team ensure they could properly position them to reduce the risk of surgery. It helped operating department practitioners prepare the medical trays and understand the equipment the surgeons required and to plan for any unforeseen emergencies.

  • People could access the service and appointments in a way and at a time that suited them.

  • All staff we spoke with were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns. There were high levels of satisfaction across all staff groups.

  • Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent, high-quality sustainable care. The hospital was led by managers who had the right skills and abilities and were compassionate, inclusive and effective.

  • Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond. Leaders had an inspiring shared purpose and strived to deliver and motivate staff to succeed.

  • Services demonstrated commitment to best practice performance and risk management systems and processes. There were effective systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected. Staff at all levels had the skills and knowledge to use the systems and processes effectively.

  • There was a demonstrated commitment at all levels to sharing data and information proactively to drive and support internal decision making as well as system-wide working and improvement.

  • There were consistently high levels of constructive engagement with staff and people who used services, including various equality groups. Services were developed with the full participation of those who used them. For example, the hospital worked with the Stroke Association, Deaf Sign Academy, Islamic and Jewish groups and patients and their families who had experience of illness such as dementia and sepsis.

However,

  • Staff did not always adhere to the documentation requirements of the surgical safety checklist, although compliance was improving. We also observed two time-out procedures that were not as comprehensive as they should have been. The hospital responded quickly to address this issue during the inspection.

  • Not all records of patient consultations in outpatients were detailed, clear and up to date.

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.

Ellen Armistead

Deputy Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 24 June 2019

We rated it as Good because:

We found the following areas of good practice:

  • 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.
  • Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.
  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
  • The service followed best practice when prescribing, giving, recording and storing medicines.
  • The service used safety thermometer results well. Staff collected safety information and shared it with staff, patients and visitors. Managers used this to improve the service.

However,

  • Staff did not always adhere to the documentation requirements of the surgical safety checklist, although compliance was improving. We observed two time-out procedures that were not as comprehensive as they should have been. The hospital responded quickly to address this issue during the inspection.

  • Not all records of patient consultations in outpatients were detailed, clear and up to date.

Effective

Good

Updated 24 June 2019

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.
  • Staff gave patients enough food and drink to meet their needs and improve their health. The service adjusted for patients’ religious, cultural and other preferences.
  • Staff assessed and monitored patients regularly to see if they were in pain.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service.
  • Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. They followed the service policy and procedures when a patient could not give consent.

Caring

Outstanding

Updated 24 June 2019

We rated it as Outstanding because:

  • Staff worked especially hard to make the patient experience as pleasant as possible. Staff recognised and responded to the holistic needs of their patients from the first referral before admission to checks on their wellbeing after they were discharged from hospital.

  • Staff cared for patients with compassion. Feedback from patients consistently confirmed that staff treated them well and with kindness.

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

  • Staff always took people’s personal, cultural, social and religious needs into account.

  • People’s emotional and social needs were as important as their physical needs.

Responsive

Outstanding

Updated 24 June 2019

We rated it as Outstanding because:

  • The service took account of patients’ individual needs.

  • Facilities and premises were innovative and met the needs of a range of people who used the service.

  • People could access services and appointments in a way and at a time that suited them. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were consistently 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.

Well-led

Outstanding

Updated 24 June 2019

We rated it as Outstanding because:

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

  • The hospital had a vision for what it wanted to achieve and workable plans to turn it into action, which it developed with staff, patients, and local community groups.

  • Leaders had an inspiring shared purpose and strived to deliver and motivate staff to succeed. There were high levels of satisfaction across all staff groups.

  • Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns, and all policies and procedures supported this.

  • The hospital had good systems to identify risks, plans to eliminate or reduce them, and cope with both the expected and unexpected. Governance arrangements were proactively reviewed and reflected best practice.

  • Problems were identified and addressed quickly and openly.

  • There were consistently high levels of constructive engagement with staff and people who used the services, including all equality groups.

Checks on specific services

Medical care (including older people’s care)

Good

Updated 24 June 2019

  • Medical care services were a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.
  • The service provided elective endoscopy and interventional cardiology procedures, and these were developing activities in the hospital.
  • We rated these services as good overall because they were safe, effective, caring, responsive and well-led. Both departments were clean, and medicines and equipment stored appropriately.

Services for children & young people

Outstanding

Updated 24 June 2019

  • Children and young people’s services were a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.
  • We rated this service as outstanding because it was safe, effective, caring, responsive and well led.
  • Staff had received up-to-date training in all safety systems, processes and practices. There were comprehensive systems to keep children and young people safe, which took account of current best practice.
  • A proactive approach to anticipating and managing risks to patients who used the service was embedded and was recognised as the responsibility of all staff.
  • The service had systems to monitor patient outcomes including various hospital-wide initiatives, and local ward based actions.
  • Consideration of children’s privacy and dignity was consistently embedded in everything that staff did, including awareness of any specific needs.
  • There was a proactive approach to understanding the needs and preferences of different groups of children, young people and their families and to delivering care in a way that met these needs, which was accessible and promoted equality.
  • Comprehensive and successful leadership strategies were in place to ensure and sustain delivery and to develop the desired leadership culture. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.

Critical care

Outstanding

Updated 24 June 2019

  • The critical care service supports the hospital’s elective surgical and medical services, accepting both planned and unplanned admissions. The critical care unit has five beds, one of which is in an isolation room. These include three high‑dependency and two intensive care beds, with sufficient flexibility to meet the acuity needs of any patient admitted to the unit.
  • We rated the critical care service as outstanding overall. This was because the service’s staff were highly motivated and had truly embedded the safety of patients as a primary focus in their day to day roles.
  • Patients were protected by a strong comprehensive safety system in the unit which focused on openness, transparency and learning when things go wrong.
  • All staff in the unit from housekeeping staff through to the unit’s and hospital’s leaders truly respected and valued their patients as individuals. Patients were empowered as partners in their care, practically and emotionally, by an exceptional and distinctive team of people.
  • This safe and caring culture was delivered in an effective and responsive way by a committed team of nursing and medical staff under the direction of an extremely strong, inclusive and innovative leadership team who were dedicated to the improvement, growth and sustainability of the service and in the delivery of high-quality person‑centred care.

Diagnostic imaging

Good

Updated 24 June 2019

  • The service provided magnetic resonance imaging scanning, computerised tomography, plain X ray, fluoroscopy, mammography and ultrasound for adults and a small number of children.
  • We rated the service as good as there were systems and processes in place to keep people safe and to reduce the risk of radiation.
  • The department was clean, and medicines were stored appropriately. There was evidence of multi-disciplinary team working and staff were deemed competent to deliver services.
  • The department used a range of national and local guidance.
  • Staff were caring, and patients were treated with privacy and dignity.
  • Patients who required additional support were provided with that support, complaints were few and were dealt with appropriately. There was a good open culture and the service was developing leaders for the future. Risk was well managed and there were appropriate governance structures in place.

Outpatients

Outstanding

Updated 24 June 2019

  • The outpatient department had 24 consulting rooms all with their own dedicated separate examination rooms. The department had four treatment rooms one with its own recovery area and a dedicated ear, nose and throat treatment room. The unit provides care for adults and children from birth.
  • All staff were fully committed to maintaining high standards of infection control.
  • Outpatient staff met the hospital target for compliance with mandatory training. Staff provided care and treatment in line with best practice and treatment was evidence-based.
  • Staff felt they were encouraged by the organisation to give patient’s a service which was focussed on compassionate care coupled with excellent treatment. Patients received timely appointments.
  • Clinical governance committee meetings took place quarterly to discuss risks, incidents and key issues and quality and performance were monitored.

Surgery

Outstanding

Updated 24 June 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 these services good overall because they were safe, effective, caring, responsive and well-led
  • The service controlled infection risk well and had low surgical site infection rates.
  • The service always looked after its equipment and premises. Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.
  • The service had enough staff to ensure a safe service. They were well trained and had regular appraisals.
  • The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
  • Staff gave patients enough food and drink to meet their needs and improve their health. Staff assessed and monitored patients regularly to see if they were in pain.
  • Staff were competent in their roles and were regularly assessed. They also worked well together to benefit patients and provide efficient care.
  • Feedback from patients confirmed that staff treated them well and with kindness.
  • The hospital ensured that its premises and staff met the needs of local people and people with individual needs. Patients could access the service at a time to suit them. Operations were rarely cancelled and those that had been were re-scheduled quickly.
  • The hospital had clear guidelines for dealing with complaints from NHS and private patients. Complaints were taken seriously, investigated quickly and learning shared.
  • The hospital had an excellent leadership team that communicated well with staff and patients. The hospital had a clear vision and strategy and gave staff the opportunity to develop their parts of the service in-line with this.
  • There was a positive culture in the hospital, with staff able to contribute ideas to improve services, or challenge poor behaviour if required.
  • The hospital had very clear governance arrangements and used these to ensure that the service was safe and could be improved where necessary.
  • The hospital managed risk well. There were several clinical groups assessing risk and monitoring staff performance.
  • The hospital engaged with staff and patients well and used feedback to develop its service.

  • The hospital had clear processes that allowed it to quickly identify issues or share best practice. It used innovation to improve patient experience.
  • However, staff did not always adhere to the documentation requirements of the surgical safety checklist, although compliance was improving. We observed two time-out procedures that were not as comprehensive as they should have been. The hospital responded quickly to address this issue during the inspection.