CircleReading

Updated 24 October 2019

CircleReading opened in August 2012. It is an independent sector hospital in Reading, Berkshire. The hospital primarily serves the communities of Berkshire and the surrounding areas. It also accepts patient referrals from outside this area. The main provision is surgery, specialities treated include: orthopaedics, spinal, general surgery, gynaecology, ENT, refractive eye surgery and endoscopy. The hospital also provides cosmetic surgery, diagnostic imaging and outpatient services.

The registered manager had been in post since April 2019.

Updated 24 October 2019

Circle Reading has 30 inpatient beds with 20-day case pods plus eight ambulatory day case chairs. The hospital has five operating theatres, three of which have laminar flow. There is an endoscopy suite within the theatre complex, as well as a suite of consulting and treatment rooms, and an imaging department offering x-ray, ultrasound and scans. The hospital also has a pharmacy on site.

Circle Reading provides a range of medical, surgical and diagnostic services to patients who pay for themselves, are insured, or are NHS funded patients. Services offered by the hospital include orthopaedics, spinal, general surgery, gynaecology, ENT, ophthalmology, endoscopy, physiotherapy and diagnostic imaging.

We inspected this service using our comprehensive inspection methodology and undertook an unannounced inspection of the service on 25 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.

Updated 24 October 2019

People could access the service when they needed it and receive the right care promptly.

The service had enough allied health professionals and medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.

Staff kept appropriate records of patients’ care and treatment. Records were clear, up-to-date and available to all staff providing care.

The service provided care and treatment based on national guidance and evidence-based practice. To support the service, there was a Radiation Protector Advisor, a radiation protection supervisor and a medical physics expert for the department.

Radiographers, radiologists, the radiography assistant, administration staff and other health professionals at the hospital worked together as a team to benefit patients.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care.

The service was inclusive and took account of patient individual needs and preferences.

It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons with all staff. The service included patients in the investigation of their complaint.

Leaders had the integrity, skills and abilities to run the service. They understood and managed priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.

The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure.

Updated 24 October 2019

The service provided mandatory training in key skills to all staff and made sure everyone completed it.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves, and others from infection. They kept equipment and the premises visibly clean.

The service had enough nursing staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed staffing levels and skill mix, and gave bank and agency staff a full induction.

The service used systems and processes to safely prescribe, administer, record and store medicines.

The service managed patient safety incidents well. Staff recognised incidents and near misses and reported them appropriately.Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients.

Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff.

The service had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy. Leaders and staff understood and knew how to apply them and monitor progress. 

However,

Staff did not keep detailed written records of patients’ care and treatment. Some patient records were very difficult to read.

The WHO Surgical Safety Checklist was not always completed for outpatient procedures. Subsequent to the inspection, the provider ensured that the checklist was used in the outpatient department.

Updated 24 October 2019

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.

The service controlled infection risk well. The service used systems to identify and prevent surgical site infections. Staff usually used equipment and control measures to protect patients, themselves, and others from infection. They kept equipment and the premises visibly clean.

Staff completed and updated risk assessments for each patient and removed or minimised risks.

The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care. The service made sure staff were competent for their roles.

The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance. Staff protected the rights of patient’s subject to the Mental Health Act 1983.

Staff assessed and monitored patients regularly to see if they were in pain, and gave pain relief in a timely way.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

The service was selective to ensure that they were able to meet the needs of individual patients. For the patients’ that met the acceptance criteria their individual needs and preferences were considered.

The service had a system for reporting and managing patient safety incidents. Staff felt able to report incidents and sufficiently confident to speak out when things went wrong.

Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients.

Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events. Staff contributed to decision-making to help avoid financial pressures compromising the quality of care.