Spire Manchester Hospital is operated by Spire Healthcare Limited. It is a new purpose built private hospital, registered by the CQC on 22 January 2017. The hospital has 37 inpatient rooms, a dedicated six bedded paediatric suite, 27-day case rooms and five critical care beds.
The hospital provides surgery, medical care, critical care, services for children and young people, outpatients and diagnostic imaging. Patients are admitted electively, there are no emergency admissions received at the hospital.
The last inspection of this provider was carried out in September 2016 where it was rated as requires improvement. Since that inspection all services have been relocated to a new hospital site in 2017, as a new registration, therefore we have not compared the previous ratings from 2016. We inspected all core services during this inspection.
We inspected this service using our comprehensive inspection methodology. We carried out the unannounced visit to the hospital on 5 February 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
We rated the hospital as Outstanding overall.
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Staff worked especially hard to make the patient experience as pleasant as possible. Staff recognised and responded to the holistic needs of their patients from the first referral before admission to checks on their wellbeing after they were discharged from the hospital.
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There was a strong, visible person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity. Relationships between people who use the service, those close to them and staff were strong, caring, respectful and supportive. These relationships were highly valued by staff and promoted by leaders. The hospital always looked after its equipment and premises. The hospital controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
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Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.
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The hospital planned and provided services in a way that met the needs of local people. It put peoples’ needs central to the delivery of tailored services.
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Opportunities to participate in benchmarking and peer review were proactively pursued, including participation in approved accreditation schemes.
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The hospital had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
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Staff, teams and services were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care to people who used services. For example, patients having complex spinal surgery would have a dry run to help the theatre team ensure they could properly position them to reduce the risk of surgery. It helped operating department practitioners prepare the medical trays and understand the equipment the surgeons required and to plan for any unforeseen emergencies.
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People could access the service and appointments in a way and at a time that suited them.
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All staff we spoke with were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns. There were high levels of satisfaction across all staff groups.
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Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent, high-quality sustainable care. The hospital was led by managers who had the right skills and abilities and were compassionate, inclusive and effective.
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Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond. Leaders had an inspiring shared purpose and strived to deliver and motivate staff to succeed.
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Services demonstrated commitment to best practice performance and risk management systems and processes. There were effective systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected. Staff at all levels had the skills and knowledge to use the systems and processes effectively.
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There was a demonstrated commitment at all levels to sharing data and information proactively to drive and support internal decision making as well as system-wide working and improvement.
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There were consistently high levels of constructive engagement with staff and people who used services, including various equality groups. Services were developed with the full participation of those who used them. For example, the hospital worked with the Stroke Association, Deaf Sign Academy, Islamic and Jewish groups and patients and their families who had experience of illness such as dementia and sepsis.
However,
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Staff did not always adhere to the documentation requirements of the surgical safety checklist, although compliance was improving. We also observed two time-out procedures that were not as comprehensive as they should have been. The hospital responded quickly to address this issue during the inspection.
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Not all records of patient consultations in outpatients were detailed, clear and up to date.
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.
Ellen Armistead
Deputy Chief Inspector of Hospitals