11-12 June 2019
During a routine inspection
Spire Little Aston Hospital is operated by Spire Healthcare Limited. The hospital has a 24 bedded surgical ward and a separate two bedded extended recovery unit, an eight bedded day case unit and a chemotherapy suite with four chairs and two private rooms. Facilities include one endoscopy theatre and three laminar flow operating theatres and X-ray, outpatient and diagnostic facilities.
The hospital provides surgery, medical care, outpatient services for children and young people, and outpatients and diagnostic imaging. We inspected surgery, medicine and outpatients.
We inspected this service using our comprehensive inspection methodology. We carried out the inspection from 11-12 June 2019
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 level.
Services we rate
Our rating of this service stayed the same. We rated it as Good overall.
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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 collected safety information and used it to improve the service.
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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.
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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.
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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.
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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:
Outpatients:
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The audio consulting room in outpatients was very small and cramped. It would not easily accommodate a patient using a wheel chair safely together with one other person beside the consultant.
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The outpatient service did not have in place an audit programme of patient records to assure continued good quality of records and records management.
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Front line outpatient staff were not active in encouraging patients and visitors to cleanse their hands.
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The hospitals policy for its Cognitive Impairment Adult Framework was incomplete and did not include ‘the outpatient phase’ as indicated was intended by the contents page.
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There were insufficient patient toilets for outpatient services demand and some degree of privacy was compromised by their location.
Endoscopy:
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There was an inconsistent approach to decontamination and hand hygiene within the endoscopy unit.
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Two sharps boxes were not assembled correctly.
Chemotherapy Suite:
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Room 63 in the chemotherapy suite needed updating to be fully compliant with HBN 00/10- part A (flooring).
Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Heidi Smoult
Deputy Chief Inspector of Hospitals