Hospital of St Cross

Updated 15 August 2025

At this latest assessment of Hospital of St Cross we reviewed 1 service group (surgery) and aggregated the ratings from our previous assessments of the 4 service groups provided at the hospital. Although safe was requires improvement at this assessment, the overall rating for the hospital remains good.

Updated 15 August 2025

University Hospitals Coventry and Warwickshire NHS Trust (UHCW) provides both elective and emergency surgery to the population of Coventry and Warwickshire with a wider catchment area for specialist services.

The trust provides surgical services on sites at University Hospital, Coventry and the Hospital of St Cross, Rugby. Surgical services at the Hospital of St Cross shares the management and governance structures with the University Hospital Coventry and some information provided was available only at trust level. At Hospital of St Cross there were 6 operating theatres, a treatment room, an inpatient ward (cedar ward) and a day surgery unit. There were 41 beds located on cedar ward and the day surgery unit had 22 beds.

We conducted a planned unannounced on-site assessment of surgical services at the Hospital of St Cross on the 25 and 26 September 2024. We followed the Care Quality Commission (CQC) Single Assessment Framework and assessed against the safe, effective, caring, responsive and well-led key questions. As part of our assessment, we looked at 9 patient records, spoke with 8 patients, 5 relatives and 44 members of staff including the leadership team for surgery (known as the triumvirate), theatre manager, ward managers, scrub nurses, anaesthetists, consultants, healthcare assistants, recovery nurses and staff nurses.

The overall rating for this service was good. Safety was rated as requires improvement, but effective, caring, responsive and well-led were rated as good.

We found: There was a good safety culture where events were investigated, and learning was embedded to promote good practice. Staff delivered good care and treatment following evidence-based practice and people had good outcomes. Staff were kind, caring and compassionate. The service was inclusive and took account of patients' individual needs and preferences, People could access the service when they needed it and received the right care promptly. Leaders operated effective governance processes and used systems to manage performance effectively.

However: There were gaps in the completion of anaesthetic check logs, and this did not provide assurance that equipment was safe to use. Flooring within theatres was worn in areas and not always compliant with the Health Building Note for flooring requirements. Staff did not always monitor expiry dates of all equipment. The patient record system did not flag patients living with special needs.

Updated 31 August 2018

Our rating of this service improved. We rated it as good because:

• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. We observed staff members were courteous and helpful to patients and treated them with dignity and respect.
• Generally, the service prescribed, gave, recorded and stored medicines in accordance with best practice. Patients received the right medication at the right dose at the right time.
• The service generally had suitable premises and equipment and looked after them according to the manufacturer’s instructions. The service generally controlled infection risk well. Most staff complied with infection prevention and control policy.
• There were effective systems in place to recognise and respond to deteriorating patients’ needs.
• Staff generally kept appropriate records of patients’ care and treatment. Records were clear, up-to-date and available to all staff providing care. Entries were clear and legible and most entries were dated and signed.
• The service generally had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• The service used safety monitoring results well. Staff collected safety information and shared it with staff, patients and visitors. The service used information to improve the service.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Audits were completed to ensure staff followed guidance and progress with implementation of guidance was monitored.
• The service monitored the effectiveness of care and treatment and generally used the results to improve them. Information about the outcomes of patient’s care and treatment, both physical and mental where appropriate, were routinely collected and monitored. This was done through local audits and national audits.
• The service made sure staff were competent for their roles. Managers appraised most staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service.
• The service had managers with the right skills and abilities to run a service providing high-quality sustainable care. Nursing staff reported that there was strong local leadership on the wards and that matrons and ward managers were both visible and supportive. They told us that they felt supported by the local management team.
• Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

However:

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. However, not all staff had received safeguarding training on how to recognise and report abuse. Staff were aware of how to recognise and report safeguarding concerns.
• The service provided mandatory training for staff, but not all had completed it to meet the trust’s standard of 95% compliance.
• There was no seven-day service provided at the hospital of St Cross within the medical service. The medical patients did not have access to physiotherapy, occupational therapy or SALT service during the weekends and bank holidays.
• People could access the service when they needed it. However, the length of stay for medical patients was higher than the England national average due in part to system wide pressures in social care support.

Updated 11 February 2020

• 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, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. 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 and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 31 August 2018

Our rating of this service improved. We rated it as good because:

• Staff cared for patients with compassion. Patients universally praised staff for their kindness and their understanding of their needs.
• Risks to patients were assessed, and their safety monitored and managed so they were supported to stay safe.
• The service had enough staff with the right qualifications, skills, training, and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• The UCC provided care and treatment that was based on national guidance.
• Staff gave patients enough food and drink to meet their needs and improve their health.
• Patients’ pain was assessed and managed well.
• The service generally took account of patients’ individual needs.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.
• The trust was planning services in a way that met the needs of local people.
• Patients could access services when they needed them.

However,

• There was a lack of visibility from senior trust leaders to the staff in the UCC.
• The service did not have a clear strategy and vision for what it wanted to achieve and lacked workable plans to turn it into action.
• Local managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values: however, recent changes in the UCC had affected morale.
• The UCC lacked a systematic approach to continually improving the quality of its services and to safeguard high standards of care.
• The service engaged with patients, staff, the public and local organisations to plan and manage appropriate services, but this could be improved.
• There was limited evidence that the UCC was committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.