Background to this inspection
Updated
26 January 2021
The hospital has two wards, only one ward is used for day cases and inpatients. The hospital has 29 beds.
Facilities also include two operating theatres, X-ray, outpatient and diagnostic facilities. Surgical services provide elective and day case surgery covering various surgical specialities including breast, colorectal, ear, nose and throat (ENT), general surgery, gynaecology, orthopaedics, ophthalmology, upper gastro-intestinal and urology. There was a small on-site pathology service.
The hospital is registered to provide the following regulated activities:
- Surgical procedures
- Treatment of disease, disorder or injury.
- Diagnostic and screening procedures.
- Family planning.
The hospital also offers cosmetic procedures, such as breast and facial surgery, we did not inspect these services as part of our inspection.
There was an investigation into the management of medicines which was ongoing by the CQC at the time of this inspection. The hospital has been inspected five times, and the most recent inspection took place in May 2019, which found that the hospital was rated as requires improvement.
Updated
26 January 2021
BMI The Huddersfield Hospital is operated by BMI Healthcare Limited. The hospital/service has 29 beds. Facilities include two operating theatres, X-ray, outpatient and diagnostic facilities.
The hospital provides surgery, outpatients and diagnostic imaging for adults. We inspected surgery, outpatients and diagnostic services.
We inspected this service using our comprehensive inspection methodology. Our inspection was unannounced (staff did not know we were coming) to enable us to observe routine activity.
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 report.
Services we rate
Our rating of this hospital/service stayed the same. We rated it as Requires improvement overall.
We found areas of practice that require improvement in the services for surgery:
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The requirements of the duty of candour regulation was not met in two cases we reviewed, actions taken did not comply with the requirements or with BMI policy. Patients did not consistently receive written information or were informed of the findings from the incident investigation. Leaders did not consistently ensure that duty of candour requirements were completed in line with regulatory requirements.
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The design, maintenance and use of facilities, premises and equipment did not keep people safe. The service did not always control infection risk well. While the environment and equipment were visibly clean, the premises were damaged, and wall and floor coverings were not always intact.
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Staff could not clearly articulate how and when to assess whether a patient had the capacity to make decisions about their care or deprivation of liberty safeguards. Records we reviewed did not provide assurance that patients were consented in line with best practice and professional standards.
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Leaders had the skills and abilities to run the service. However, there was some instability and change in terms of gaps in the senior leadership team at the time of inspection, once fully recruited, the team would need a further period to embed to be consistently effective.
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Leaders operated clear governance processes throughout the service. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service. However, due to the instability of the management team these required a further period to embed to be consistently effective.
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The service did not consistently use systems and processes to safely prescribe, administer, record and store medicines.
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Staff we spoke with said they felt respected, supported and valued. However, the hospitals own staff survey results did not correlate this view.
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Data we reviewed showed that the organisation was not consistently timely with the complaint investigation response.
We found areas of practice that require improvement in in relation to outpatient care:
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The design, maintenance and use of facilities, premises and equipment did not always help to keep people safe.
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The service did not always have enough nursing and support staff with the right qualifications, skills, training and experience available to provide the right care and treatment.
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Staff kept records of patients’ care and treatment. However, these were not always clear, up to date or stored securely.
However, we found the following areas of good practice in diagnostic imaging:
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The service-controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
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Staff assessed risks for each patient and ensured they were removed or minimised.
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The service provided care and treatment based on national guidance and best practice.
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Leaders had the skills and abilities to run the service.
Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notice(s) that affected the core services of surgery and outpatients. Details are at the end of the report.
Ann Ford
Deputy Chief Inspector of Hospitals (North)
Updated
23 December 2019
Diagnostic 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. We found the service was safe, effective, caring, responsive and well led.
Updated
23 December 2019
Outpatients 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. We found the service was effective, caring, responsive and well led.
Updated
23 December 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 requires improvement because it was not consistently safe, effective, responsive or well-led.