The Ridgeway Hospital

Updated 29 June 2022

The Ridgeway Hospital is operated by Circle Health Group Limited. The hospital provides outpatient, diagnostics, surgery and medical care including oncology and endoscopy services to adults. Treatment is provided to privately funded and NHS patients. Specialties offered by the service for inpatients and outpatients include genecology, ears, nose and throat (ENT), breast and cosmetic surgery, chemotherapy and oncology, and refractive eye surgery.

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.

From October 2019 to September 2020 two thirds of procedures carried out at this service were privately funded and one third were performed on behalf of the NHS.

The three most commonly performed inpatient procedures in this timeframe were:

Hip replacement

Spinal decompression

Knee replacement

The three most commonly performed day case procedures in this timeframe were:

Cataract surgery

Chemotherapy

Diagnostic upper gastrointestinal endoscopy

What people who use the service say

They feel safe and well looked after, that staff are friendly and helpful, and the nurses are so nice. One patient gave the hospital the following feedback “I have had the most wonderful care from every single person. I could not have been made to feel more cared for. The care was above and beyond what I could have hoped for. Thank you”.

Updated 29 June 2022

We carried out a comprehensive inspection of The Ridgeway Hospital on 15 and 16 March and 30 and 31 March 2022. Medical Care and surgery services were last inspected in March 2018, medical services were rated as ‘good’ and surgery as ‘requires improvement’. The service was last comprehensively inspected in April 2016 and was rated as requires improvement overall. At that time, the outpatient’s department and diagnostic imaging was inspected under one inspection framework. The Care Quality Commission (CQC) now inspects diagnostic imaging and outpatients as separate core services.

The Ridgeway Hospital provided the following services: surgery (several specialties to include general, orthopedic and cosmetic), medical care (for example, chemotherapy and endoscopy) outpatients and diagnostic imaging. We inspected all these service during this inspection.

Before the inspection we reviewed information we had about the location, including information we received and available intelligence. The inspection was unannounced.

We rated safe as good in medical care and diagnostic imaging and requires improvement in surgery and outpatients. Effective was rated as good in surgery and medical care but is not rated in outpatients and diagnostic imaging. Responsive, caring, and well-led was rated as good in all four services inspected.

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. Most staff understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed medical risks to patients and acted on them. 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 health 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 them to give feedback. Patients could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. 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 some community services to plan and manage services and all staff were committed to improving services continually.

However:

• Not all staff received training in safeguarding children.
• Not all staff followed policy when completing care records.
• The mental capacity, deprivation of liberty and restrictive practice policy did not always include accurate and up to date information for staff to provide safe care and treatment.

Updated 29 June 2022

Our rating of this service stayed the same. We rated it as good because:

• The service had enough staff to care for patients. Staff had training in key skills and understood how to protect patients from abuse. 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 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.

Medical care is 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 in safe, effective, caring, responsive, and well-led.

Updated 29 June 2022

Diagnostic imaging is 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 previously inspected diagnostic imaging jointly with outpatients so we cannot compare our ratings with previous ones. We rated this service as good because it was safe, caring, responsive and well-led. We do not rate effective in diagnostic and imaging services.

• 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 provided good care and treatment, gave patients enough to eat and drink. 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 to suit patients' needs.
• 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 29 June 2022

Outpatients is 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 previously inspected outpatients jointly with diagnostic imaging so we cannot compare our ratings with previous ones. We rated this service as good because it was caring, and responsive, and well led. We do not rate effective in Outpatients.

In the outpatient department there were 12 consulting rooms, including a dedicated ophthalmic room, ear nose and throat room and a treatment room for minor procedures. Clinics were held from 8am to 8pm Monday to Friday in audiology, cardiology, dermatology, dietetics, ear, nose and throat (ENT), gastroenterology, general medicine, general surgery, gynaecology, haematology, neurology, oncology, ophthalmology, orthopaedic, pain management, pathology, psychiatry, cosmetic plastic surgery, reconstructive plastic surgery, podiatry, psychology, radiology, rheumatology, sports and exercise medicine and urology. The clinics were able to extend providing a service on Saturdays if required.

The physiotherapy department has a gymnasium with 3 treatment cubicles, a hydrotherapy pool and 3 separate consulting/treatment rooms. Sessions were held from 8am to 7pm Monday to Friday with the ability to provide a service on Saturdays if required. From September 2020 to August 2021 there were 6,510 patients seen in outpatients.

During our inspection, we visited the outpatients’ department where clinics in general medicine, general surgery, ophthalmology, orthopaedics, ENT, oncology and urology were being held. We also visited the physiotherapy outpatient department. We spoke with five patients and 16 members of staff, including managers, doctors, nurses, allied health care professionals, health care assistants and non-clinical staff.

We rated Outpatients 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 risks to patients and acted on them. 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, 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 and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity 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 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:

• Consultants did not consistently keep contemporaneous patient records.
• Not all staff received the appropriate levels of safeguarding children training in line with the intercollegiate guidance documents.
• Not all staff had enough knowledge of the mental capacity act and its code of practice to enable them to support all patients to make decisions about their care.
• Staff did not always have the skills, or tools available, to enable them to support patients with additional communication needs.
• Not all areas of the estate were kept visibly clean.

Outpatients is a small proportion of the hospital’s activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

Updated 29 June 2022

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

• The service had enough staff to care for patients and keep them safe. Staff mostly 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 mostly 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:

• Not all staff received safeguarding children training in line with the intercollegiate guidance document.
• The mental capacity, deprivation of liberty and restrictive practice policy did not always include accurate and up to date information for staff to provide safe care and treatment

We rated this service as requires improvement in safe, and good in effective, caring, responsive, and well-led.