Tees Valley Hospital

Updated 28 March 2022

Tees Valley hospital is an independent hospital owned by Ramsay healthcare. It is registered to provide the following regulated activities:

• Treatment of disease, disorder or injury,
• Surgical procedures,
• Diagnostic and screening procedures,
• Family planning services.

The hospital has a manager registered with CQC.

The hospital provided a range of elective surgery treatments for NHS and other funded (insured and self-pay) adults, with a range of specialities including general surgery, dermatology, gastro-intestinal endoscopy, gynaecology, oral surgery, podiatric surgery, urology, elective orthopaedics, and cosmetic surgery.

The surgery service had an in-patient ward, (Mary Jacques ward) with 19 inpatient beds, across seven single and six double rooms. There was also a dedicated pre-assessment clinic with two rooms.

There was an ambulatory day care unit, with 12 ‘pods’; each had a reclining chair. There were three operating theatres and a dedicated endoscopy suite.

The diagnostic imaging department provided direct digital X-Ray, ultrasound and interventional procedures. The consultant radiologists could perform general, gynaecological and musculoskeletal ultrasound scans. The musculoskeletal radiologists could offer a variety of guided injections and treatments.

Outside of the department there were MRI and CT scan facilities operated by a different registered provider. Therefore these were not included in our inspection.

There was a dedicated out patient's department.

Our inspection was unannounced (staff did not know we were coming). This was the first time we had inspected this service.

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.

Updated 28 March 2022

• The patient environments were safe, clean and well maintained.
• The service followed good practice with respect to safeguarding.
• The service always had enough staff. Managers ensured that these staff received training, and appraisal. The staff worked well together as a multidisciplinary team
• Care plans were individualised and included discharge plans.
• Staff planned patient discharge well and liaised with services that would provide aftercare. Patients lengths of stay were short.
• Staff engaged in clinical audit to evaluate the quality of care they provided.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood their individual needs. They involved patients and families and carers in care decisions.
• The service was well led, and the governance processes ensured that procedures ran smoothly.

However:

• Some potentially hazardous areas on the ward were not always secure. For example, the domestic store room and dirty utility room were unlocked, which allowed potential unauthorised access.
• Staff did not always manage medicines in accordance with local policy. For example, patient unique identification numbers were not always recorded in the controlled drug register on the ward. In the outpatient department, medicines that had reached expiry date were not always removed promptly.
• Staff we spoke with told us they did not attend clinical supervision, nor was it offered by managers.

Updated 28 March 2022

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 to suit patients' needs and 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.

Diagnostic Imaging is a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

We rated this service as good because it was safe, effective, caring, responsive and well-led.

Updated 28 March 2022

• 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. 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

• Medicines that had reached expiry date were not always removed promptly.

Outpatients was a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section. We rated this service as good because it was safe, effective, caring responsive and well-led.

Updated 28 March 2022

• 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 mostly 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 ensured patients had access to good information. Most 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 most 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:

• The domestic store room and dirty utility room on the ward were unlocked, which meant there was a potential risk of unauthorised access.
• Staff did not always record patient unique identification numbers in the ward controlled drug register.
• Staff we spoke with told us they did not attend clinical supervision, nor was it offered by managers.

We rated this service as good because it was safe, effective, caring, responsive and well-led.