The Care Quality Commission
  • Hospital
  • Independent hospital

The Duchy Hospital

Overall: Good read more about inspection ratings

Queens Road, Harrogate, North Yorkshire, HG2 0HF (01423) 567136

Provided and run by:
Circle Health Group Limited

Latest inspection summary

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Background to this inspection

Updated 9 February 2024

BMI Healthcare joined the Circle Health Group in January 2020. The Duchy Hospital was benefitting from a major £250m national investment programme in facilities, technology, and people.

The hospital primarily serves the local communities in and around Harrogate but will accept patient referrals from outside this geographical area.

The Duchy Hospital has a new registered manager who was registered through the Care Quality Commission on the 5 October 2023.

The hospital provides a range of surgical, outpatient and diagnostic imaging services to the NHS and other funded (insured and self-pay) patients and collaborates predominately with consultants from local NHS hospitals. Surgical services at the Duchy Hospital provide day and overnight facilities for adults only undergoing a variety of procedures.

The hospital has access to the latest technology and equipment including:

Two theatres with laminar flow and a minor procedures suite

Diagnostic Imaging X-Ray and Ultrasound

27 private rooms with ensuites

10 Consulting Rooms

Holistic and Wellbeing Programme - Yoga and Pilates

Physiotherapy Suite

Health Screening

The hospital was inspected on 31 July 2017 for safe and well led. A requires improvement rating was awarded following this inspection.

We rated well-led as requires improvement because:

    • Although there were many improvements in governance, leadership, staff and public engagement and staff morale/ culture many of the new processes and initiatives were still in their infancy. The hospital leaders knew they had more to do to ensure they were embedded, and improvement sustained.
    • Improvements had been made in the hospitals approach to the Workforce Race Equality Standard (WRES) but the hospital leaders acknowledged they were not yet fully compliant with the requirements.

At this inspection we observed ongoing improvements had taken place and were sustained. Governance, performance, and risk processes were now embedded and evidence of this was seen through the performance dashboard, audit and monitoring processes employed and feedback from staff and patients. The service was now fully compliant against the Workforce Race Equality Standard.

This inspection was unannounced.

The hospital is registered to provide the following regulated activities:

  • Diagnostic and screening procedures
  • Treatment of disease, disorder, or injury
  • Surgical procedures
  • Family Planning

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 surgical service.

Overall inspection

Good

Updated 9 February 2024

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

  • 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 most patient risks, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink. Staff gave patients pain relief. 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.

However:

Surgery:

  • The theatre doors did not stay open: staff said a quote to replace the doors had been obtained; in the interim this was identified as a risk on the risk register.
  • The resident medical officer did not attend all meetings which were relevant to them.
  • Oxygen prescribing was inconsistent in that the dose and frequency of oxygen administration was not documented clearly in one patient’s prescription chart.
  • Environmental temperature monitoring in the ward dirty utility area had not been reported when the agreed temperature was exceeded.
  • We observed staff interaction with two patients and observed on both occasions the patients were not asked to confirm their pain scores.

Outpatients:

  • Although items of equipment we checked were in date for service, labels indicating service dates were obscured on some items. We noted monthly reports are run to assure all hospital equipment is in date.
  • Although patient records were complete some were not in chronological order or integrated into the care records.

Diagnostic imaging:

  • Although not part of the inspection we visited the reception desk in the reception area under construction. We subsequently spoke with the registered manager to ensure the reception desk area was wheelchair accessible, reflecting the requirements of patients with a physical disability. The hospital immediately reflected our comments in the project construction. Following the inspection, the provider confirmed the following. We have reviewed the wheelchair accessibility at the imaging reception desk to ensure wheelchair accessibility and we are assured that access is available at main reception desk.
  • Although items of equipment we checked were in date for service, labels indicating service dates were obscured on some items. We noted monthly reports are run to assure all hospital equipment is in date.
  • For the visiting mobile magnetic resonance imaging vehicle, we were assured that when this service is on site it falls under the hospital’s policy and governance processes. However, on inspection we did not find these processes were documented.

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