The Winterbourne Hospital

Updated 15 September 2022

The Winterbourne Hospital is part of Circle Health Group Limited. In January 2020, Circle Health Holdings Limited (Circle) acquired the BMI Healthcare Limited group. The hospital is located in Dorchester and serves the local population treating privately funded patients and NHS patients. Surgery is provided for inpatients and day-case patients. The hospital did not provide services for children or young people under 18 years. The hospital had 31 beds, two operating theatres, a minor operations room, diagnostic imaging department, ambulatory care area and outpatient department.

The provider is registered to provide four regulated activities:

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

During this inspection, we looked at the following services: surgery, outpatients and diagnostic and screening procedures. We inspected the hospital as part of our routine comprehensive inspection programme for independent healthcare services.

Hospital activity:

From June 2021 to May 2022 there were 939 NHS-funded admissions and 9,385 NHS-funded outpatient and diagnostic attendances at The Winterbourne Hospital.

From June 2021 to May 2022 The Winterbourne Hospital had provided 2,619 private patient admissions and 29,559 private outpatient and diagnostic attendances.

Track record on safety for the period from June 2021 to May 2022:

One death had occurred within 30 days of surgery.

No never events had been reported - A never event is a serious incident that is wholly preventable as guidance, or safety recommendations providing strong systemic protective barriers, are available at a national level, and should have been implemented by all providers. They have the potential to cause serious patient harm or death, has occurred in the past and is easily recognisable and clearly defined.

No external review or investigations have been undertaken.

There were no incidences of healthcare acquired infections.

The service had received 22 formal complaints in the last 12 months.

No Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) reportable incidents have occurred.

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.

Updated 15 September 2022

We carried out a comprehensive inspection of The Winterbourne Hospital on 8 and 9 June 2022. The service was inspected in January 2016 and was rated as requires improvement in safe, effective and well led with good in caring and responsive. The service was rated as requires improvement overall.

The Winterbourne Hospital provided the following services: surgery, outpatients and diagnostic and screening procedures. We inspected all of these services during this inspection. The inspection was unannounced.

We rated safe as good in surgery and diagnostic imaging. In outpatients, it was rated as requires improvement. Effective was rated as good in surgery. We do not rate effective in outpatients or diagnostic imaging. Caring was good in surgery, outpatients and diagnostic imaging. Well led was rated as requires improvement for surgery, outpatients and diagnostic imaging.

Our rating of this location stayed the same. We rated it as requires improvement because:

• During the recruitment of some staff, not all the required information was obtained prior to them starting work at the service.
• Not all staff followed policy when completing care records.
• There was a lack of escalation reporting and oversight of some areas.

However:

• 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 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 mostly 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 to plan and manage services and staff were committed to improving services.

Updated 15 September 2022

This was the first inspection of diagnostic imaging as a standalone service. At this inspection we rated it as good:

• 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 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 15 September 2022

Our rating of this service went down. We rated it as requires improvement because:

• Although we found the service largely performed well, it did not meet legal requirements relating to governance. This is in relation to improving quality of record keeping and recruitment.
• Not all clinicians were observed to practice effective handwashing and cleaning of surfaces between patient care.
• Not all staff were trained to the appropriate level of adult and children safeguarding.
• The service did not have a competency framework with the required training for each staff role.
• The service did not consider the provision of chairs for bariatric visitors and carers.

However:

• The service had enough staff to care for patients and keep them safe but did not always have enough nurses. 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. 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.
• 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 to plan and manage services and all staff were committed to improving services.

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.

Updated 15 September 2022

Our rating of this service 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 risks to patients, acted on them and kept good care records. They managed medicines well.
• 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.

However,

• The recruitment and selection procedures did not ensure all appropriate checks were confirmed before staff were employed.
• There was a lack of formal risk assessments, escalation and oversight checks.

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