Spire South Bank Hospital

Updated 10 February 2022

Spire South Bank is a private hospital in the centre of Worcester. The building was originally established as a nursing home but was developed and re-opened as a hospital in 1986. Following our last inspection in 2016 the hospital had received a refurbishment which provided modern premises.

The registered manager has been in post since June 2020 and the director of clinical services had been appointed in March 2021.

The hospital provides outpatient services and surgical procedures to adults.

The operating facilities at the hospital include two laminar flow theatres, one laparoscopic theatre and a JAG accredited endoscopy suite. There are two main inpatient wards and a day case suite, with 25 beds in total.

The outpatient department is comprised of 10 consultation rooms and three treatment rooms. There are also separate units for oncology and haematology, the Spire Eye Centre (SEC), a breast unit and a bone and joint clinic.

The hospital provides imaging and physiotherapy, in addition to a pharmacy department providing services for both inpatients and outpatients.

During our inspection, we visited the surgical services within the hospital. This service included the ward areas and the operating department.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit on 2 December 2021.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of the service: 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.

As part of our inspection we reviewed the well led aspect of the senior management within the hospital.

The hospital is managed by Spire Healthcare and is part of a network of over 35 hospitals. The hospital provides care for private patients who are funded by their insurance companies or are self-paying. Patients funded by the NHS, mostly through the NHS referral system, can also be treated at Spire South Bank Hospital.

Updated 10 February 2022

Following the inspection, a ratings aggregation meeting was held to discuss the overall hospital rating.

The overall rating for Spire South Bank Hospital has now been rated Good.

The mitigation used to deviate from the ratings aggregation was based on the following information:

• Surgery is the main activity within the hospital, during the recent inspection, ratings for all the key questions have been rated as good.
• The provider met all the ‘Should’ requirements set out in the previous inspection immediately following the inspection and are no longer providing care for Children and Young People.

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. 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, 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:

• Storage of equipment was an issue within the ward and theatres, which meant some areas were cluttered. This did not impact on patient safety or access to areas.

Updated 6 November 2017

We rated outpatients and diagnostic imaging services as requires improvement for safety and well-led and good for caring and responsive. CQC does not have the methodology to rate the effective domain.

Not all staff were trained to the right level of safeguarding. In addition, staff who were trained to the right level, were not necessarily scheduled to work when there were children in the hospital.

Most of the staff were unclear of the procedure to report safeguarding concerns externally and told us that they would refer concerns to their line manager and/or matron.

Suitable arrangements were not in place to ensure advice could be obtained from a registered nurse (child branch) when children attended for appointments. However, we raised this with the hospital director who agreed to cease treating children with immediate effect.

Patient records maintained by the imaging department were not always legible. Records in the main outpatient department (OPD) area were not always stored securely although these were in private consulting rooms rather than in public areas

Conversations about patients between staff could be overheard by other patients.

There were no formal supervision arrangements in place.

There was no hearing loop in main outpatients.

The hospital had a clear vision and this was displayed throughout the hospital, on all desktops and formed part of the annual enabling excellence programme. Despite this not all staff were aware of it.

A business plan had been developed although this lacked strategic direction and was not supported by clear objectives and milestones.

Outpatient meetings were not held regularly and there was no discussion around performance of the department.

Outpatient performance was not discussed at the Clinical Governance Committee.

The risk register was not used to identify and record local risks faced by the hospital.

Care and treatment was delivered in line with evidence-based guidance.

Patients’ nutritional and hydration needs were met.

Patients’ pain levels were assessed and managed according to their need.

Information about the outcomes of patient care and treatment was routinely monitored.

Staff had the right qualifications, skills and knowledge to do their job.

Multidisciplinary team (MDT) working practices were in place.

Information about patients and clinical guidance was available to staff and provided in a timely manner.

Staff had an understanding of the relevant consent and decision making requirements of legislation.

Staff understood people’s needs and provided compassionate care.

Clinical staff communicated well with patients so that they understood their care and treatment options.

Staff understood the impact of treatment for patients and those close to them and took the time to listen to their concerns.

Services were planned and delivered in a way that met the needs of the local population and flexibility was reflected across each of the outpatient services.

Care and treatment was accessible at the patients’ convenience.

‘One-stop’ clinics for some specialities were available so patients could undergo tests and a consultation within the same appointment to minimise patient attendances.

98% of NHS patients were seen by a consultant within 18 weeks of their initial referral. Private patients were seen very rapidly.

The services had processes in place to manage patients with complex needs, including those with a learning disability.

Information on complaints or how to raise a concern was available to patients. Complaints and concerns were responded to in line with the complaints policy.

Each area of outpatients was overseen by a head of department, with exception of the breast unit, radiology staff reported to the imaging head of department and nursing staff reported to the outpatients’ head of department.

The views of staff and patient views and experiences were gathered and action plans developed to improve the service.

Updated 10 February 2022

Our rating of this service stayed the same. 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. 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.

However:

• Storage of equipment was an issue within the ward and theatres, which meant some areas were cluttered. This did not impact on patient safety or access to areas.