Spire Bushey Hospital

Updated 2 December 2021

Spire Bushey Hospital is a purpose-built private hospital managed by Spire Healthcare. The hospital provides care for private patients who are either covered by their insurance companies or are self-funding. Patients funded by the NHS, mostly through the NHS referral system can also be treated at Spire Bushey Hospital. There are two inpatient wards, Lea Ward is on the ground floor and Gade Ward is on the first floor. There are 80 patient bedrooms, 68 with en suite and 12 day care rooms. On the day of our inspection Gade Ward, which is used for day cases, was not in use. There are six operating theatres, four with laminar flow. The services include, but are not limited to, orthopaedics, gynaecology, general surgery, urology and ophthalmology. Pre-assessments are carried out at Spire Bushey Diagnostic Centre, which is a short distance from the main hospital site. All patients are admitted and treated under the direct care of a consultant and medical care is supported 24 hours a day, seven days a week by an onsite resident medical officer (RMO). Patients are cared for and supported by registered nurses, care assistants and allied health professionals such as physiotherapists who are employed by the hospital. At the time of our inspection, there was a hospital director and interim director of clinical services.

We last inspected the service in January 2021 and in response to the concerns we found we issued the hospital with a Section 29A warning notice. We carried out a further focused inspection on 28 September 2021 to follow up on their compliance to the warning notice.

Updated 2 December 2021

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. 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. Key services were available seven days a week.
• 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.

However:

• The chair of the Medical Advisory Committee (MAC) and Director of Clinical Services were not permanent staff
• There was not full oversight of what was on the risk registers
• The medication cupboards in theatre were not locked
• Not all agency staff inductions were complete

Updated 19 March 2021

We did not inspect this core service at this inspection.

Updated 19 March 2021

We did not inspect this core service at this inspection.

Updated 2 December 2021

Our rating of this service improved. We rated it as good because we rated safe, effective and well led as good. We did not inspect caring or responsive as part of this inspection.

Updated 9 January 2018

The service was inspected but not rated.

Staff caring for young people did not have the appropriate level of safeguarding training.

There was no registered nurse (child branch) managing the care of young people admitted to the hospital. The hospital did not have access to registered nurses (child branch) to care for children and young people.

There was no evidence that the termination of pregnancy service was discussed or reviewed at any committee meeting.

Not all HSA1 forms had a reason for termination documented in line with legislation.

Not all patient records had evidence that a HSA4 form had been completed and sent to the chief medical officer within 14 days to comply with the Abortion Act 1967.

Records did not always contain consistent information to demonstrate all aspects of patients care or medicines received.

There was no screening for sexually transmitted diseases in place. There were no processes in place for patient referral to obtain screening. This does not comply with national guidance.

Some records contained errors that had been crossed out but there were no initials to state who had rectified this error or crossed the previous content out.

Audits did not always accurately reflect the evidence we saw in patient records, this was non-compliant with Department of Health Required Standard Operating Procedures (RSOP) and was not always identified or addressed.

Action plans did not always address areas of non-compliance following audits.

Patients were protected from abuse and avoidable harm, as staff knew how to recognise untoward incidents and safeguarding concerns, and report them appropriately. There were arrangements in place to share and action any identified learning points following incidents.

Robust procedures were in place for managing medicines used in terminations. All staff within the service and pharmacy team were aware of legislation surrounding medicines used in terminations.

Patients underwent thorough assessments prior to any treatment being delivered, with any potential risks documented and explained to patients.

Procedures were in place to ensure effectiveness of both medical and surgical terminations; the service had a 0% failure rate.

Staff understood the need to show care and compassion towards patients who had decided to undergo a termination, and were aware of the emotional impact this may have on patients.

Services were easily and readily accessible to patients, with clinics available at various times throughout the week, including one weekend day.

Clinical audit plans were in place within the service that were compliant with RSOP.

The corporate risk registered identified the appropriate risks relating to the service.

There was an inclusive and team-working culture throughout the service, with a drive for effective patient care.