Nuffield Health Guildford Hospital

Updated 18 July 2019

Guildford Hospital is operated by Nuffield Health. The hospital opened in 1999 with a significant refurbishment and extension in 2012. It is a private hospital in Guildford, Surrey. The hospital primarily serves the communities of Surrey. It also accepts patient referrals from outside this area.

The hospital has one ward and is registered to provide the following regulated activities:

• Treatment of disease, disorder and injury.
• Surgical procedures
• Diagnostic and screening procedures
• Family planning

The hospital has a registered manager in post. At the time of the inspection, a new hospital director had recently been appointed and was registered as the registered manager with the CQC in January 2019.

The service had four previous inspections, the most recent in November 2016 when the service was rated as good overall. There was one requirement notice requiring the service to ensure that patient records contain a complete record of care delivered and decisions taken in relation to care and treatment provided to service users.

Updated 18 July 2019

Guildford Hospital is operated by Nuffield Health. The hospital has 49 beds and is an independent hospital. Facilities include four operating theatres, oncology unit, outpatient and diagnostic facilities.

The hospital is located in Guildford and is sited close to the local NHS trust Hospital. The hospital provides surgery, medical care including oncology, services for children and young people, outpatients and diagnostic imaging.

We inspected the service using our comprehensive inspection methodology. We carried out an unannounced visit to the hospital on the 10 and 11th April 2019. We inspected surgery, medical care, services for children and young people and outpatients.

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

Our rating of this hospital stayed the same. We rated it as Good overall.

We found good practice in relation to:

• 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.
• The service controlled infection risk well and had suitable premises and equipment and looked after the general environment well.

• Staff completed and updated risk assessments for each patient and kept detailed records of patients’ care.
• In all areas caring for adults 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 provided best practice when prescribing, dispensing, recording and storing medicines.
• The service managed patient safety incidents well by completing investigations and learning from outcomes. The service used safety monitoring results well and used them to initiate change of practice.
• Staff gave patients enough food and drink to meet their needs and improve their health, the service made adjustments for patient’s religious, cultural and other preferences.
• The staff assessed and monitored the patients regularly to see if they were in pain and audited outcomes to improve care.
• The service provided care and treatment based on national guidance and a local audit plan was established to check effectiveness.
• All staff had an appraisal and the service made sure staff were competent for their role and supported their professional development.
• Staff of different kinds worked together as a team to benefit patients.
• Staff understood how and when to assess whether a patient had the capacity to make their decisions about their care and followed procedure when a patient could not give consent.
• Staff cared for the patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness and provided emotional support.
• 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 patients. The service took account of patient’s individual needs.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results and shared these with staff.
• Managers at all levels had the skills and ability to run a service and shared a corporate strategy, vision and values with the staff of what it wanted to achieve.
• Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The service systematically improved service quality and safeguarded high standards of care by creating an environment for clinical care to flourish.
• The service engaged well with patients, staff and local organisations and collaborated with partner organisations effectively.

We found areas of outstanding practice in the oncology service, surgery and children’s and young people’s service.

• Oncology patients could be referred to a personal trainer as part of the hospital’s ‘Recovery Plus’ initiative. This was a personalised training programme which was part of the patient’s care planning.
• The implementation of monthly scenario training for all staff developed learning and auditing of clinical practice. Staff had put their scenario training into practice in a critical situation and the learning was shared nationally across the Nuffield hospitals.
• Information for children and young persons was clearly displayed on the ward in books, information leaflets, on boards and addressed general wellbeing as well as specific hospital admission information. The information was current and in line with best practice.

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

Nigel Acheson

Deputy Chief Inspector of Hospitals (South)

Updated 18 July 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.

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

Updated 18 July 2019

Children and young people’s services was 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 good because it was safe, effective, caring and responsive and well led.

Updated 18 July 2019

Outpatients services were a significant 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 good because it was safe, caring and responsive and well led. We do not rate effective in outpatients.

Updated 18 July 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.

Staffing was managed jointly with medical care.

We rated this service as good because it was safe, effective, responsive and well-led. Caring was found to be outstanding.