• Hospital
  • Independent hospital

The Park Hospital

Overall: Good read more about inspection ratings

Sherwood Lodge Drive, Burntstump Country Park, Arnold, Nottingham, Nottinghamshire, NG5 8RX (0115) 966 2000

Provided and run by:
Circle Health Group Limited

All Inspections

30 May 2019

During an inspection looking at part of the service

BMI The Park Hospital is operated by BMI Healthcare Limited. The hospital has 66 beds. Facilities include five operating theatres, a five-bed level two care unit, and X-ray, outpatient and diagnostic facilities.

The hospital provides surgery, medical care and outpatients and diagnostic imaging. We inspected surgery.

We carried out an unannounced focused inspection of BMI The Park Hospital on 30 May 2019, in response to concerning information we had received in relation to the management of the regulated activities at this location.

During this inspection we inspected using our focussed inspection methodology. We inspected the key questions of safe and well-led only. We did not provide an overall or key question rating at this inspection, as we did not carry out a comprehensive inspection.

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.

Our findings were:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff knew how to access systems to allow them to complete their training
  • 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 most infection risks well. The service used systems to identify and prevent surgical site infections. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use equipment. Staff managed clinical waste well.
  • Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.
  • The service had enough nursing and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
  • The service had enough 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 kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.
  • The service used systems and processes to safely prescribe, administer, record and store medicines.
  • The service managed patient safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.
  • Leaders had the integrity, skills and abilities to run the service. 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.
  • The hospital had a vision for what it wanted to achieve and a set of values, to turn it into action. The vision and values were patient focused.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service had an open culture where staff could raise concerns without fear.
  • Leaders operated effective governance processes throughout the service. Staff at all levels were clear about their roles and accountabilities.
  • 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 could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements.
  • Leaders and staff actively and openly engaged with patients and staff to plan and manage services. They collaborated with partner organisations to help improve services for patients.
  • All staff were committed to continually learning and improving services.

However:

  • Having a carpet in the corridor did not conform with Health Building Note 00-09: Infection control in the built environment.
  • In two treatment rooms, both for clinical use, taps were aligned to run directly into the drain aperture. This meant contamination from the waste outlet could be mobilised and did not conform with Health Building Note 00-10 Part C.
  • We found inconsistences with daily temperature checks and found there was a total of 11 days between 1 March 2019 and 30 May 2019 where there had been no fridge temperature checks.

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.

Nigel Acheson

Deputy Chief Inspector of Hospitals

23 May 2018

During an inspection looking at part of the service

BMI The Park Hospital is operated by BMI Healthcare Limited. The hospital has 56 beds across two wards. Facilities include five operating theatres (one of which is allocated as endoscopy), a five-bed critical care unit with three beds allocated to level three care, a cardiac catheterisation laboratory and X-ray, outpatient and diagnostic facilities.

The hospital provides surgery, medical care and outpatients and diagnostic imaging. We carried out an unannounced focused inspection of the safe key question in surgery and medical care on 23 May 2018 in response to concerning information we had received about the safety of patient care and treatment across these services.

The main service provided by this hospital was surgery. Where our findings on medical care for example, medicines also apply to other services, we do not repeat the information but cross-refer to the surgery core service.

At our last inspection in September 2016 we rated the hospital as good overall; our rating for safe in medical services was good and surgical services was requires improvement.

Following this unannounced inspection our rating for safe in medical services stayed the same and our rating for safe in surgical services improved from requires improvement to good.

We found good practice in relation to medical care:

  • The service managed staffing effectively and had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
  • Arrangements to safeguard adults and children were in place and staff had received effective training in safeguarding adults and children at a level appropriate for their role.
  • Standards of cleanliness and hygiene were appropriately maintained, there were reliable systems in place to prevent infection and protect people from a healthcare-associated infection. Patient-Led Assessments of the Care Environment’ (PLACE) results were above the England average and local hand hygiene audits showed 100% compliance.
  • Recording of all medical information was timely, accurate and legible. However, none of the medical records included the medical practitioner’s general medical council (GMC) number.
  • Risks to patients were assessed, and their safety monitored and managed so they were supported to stay safe. Staff consistently identified and responded appropriately to changing risks to patients, including for example, the deteriorating patient.
  • The service had a good track record on safety.

We found good practice in surgery:

  • Protected time was allocated for staff to complete mandatory training, including safeguarding training relevant to their role. This included training on female genital mutilation (FGM).
  • Recording of all medical information was timely, accurate and legible. However, none of the medical records included the medical practitioner’s general medical council (GMC) number.
  • When the critical care unit was in use, it was led by an intensivist. There was 24-hour immediate access to the intensivist or an on-call anaesthetist.
  • Staff adhered to policies and protocols which kept patients safe from infection. This included wearing appropriate clothing within the theatre environment.
  • Staff were encouraged to report significant events. These were used as scenarios in training sessions to inform staff of any changes in process and for sharing learning.
  • Integrated records/care pathway documentation were used to ensure all relevant information and risk assessments were documented throughout the patient journey.
  • There was a paediatric nurse available who led and coordinated the care of children (aged 12-18 years).

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 (Central Region)

7 July 2014

During an inspection looking at part of the service

During our visit we spoke with five patients who were receiving treatment at the hospital. Everyone we spoke with spoke highly of the staff and the care they received. Patients said staff always introduced themselves and knocked before entering bedrooms.

Patients told us they had been given sufficient information about their care and treatment and had been asked for their consent. They confirmed that any risks relating to surgery had been explained.

Patients received their medications as they were prescribed. Staff regularly asked patients about the level of pain they were experiencing and gave pain relieving medicines if they were needed.

Medicines were suitably stored in lockable cupboards and the temperature of medicine storage areas was monitored.

Staff received appropriate professional development. We found that staff were properly supported to provide care and treatment to patients who use this service.

Senior managers had ensured that all new staff had completed inductions when they began working at the hospital.

A range of record audits were completed to assess if they were being completed fully and correctly. We saw that immediate actions had been taken to rectify any gaps but long term action plans to address systemic problems such as consultants forgetting to sign records had not been considered.

25 October 2013

During a routine inspection

We visited the location to carry out a scheduled inspection. However, we also carried out the inspection to check that the provider had met the compliance action that we set at our previous inspection on 1 November 2012.

We spoke with seven patients, all of whom confirmed they had signed consent forms before their treatment began. Feedback from all the patients was positive regarding the care that they had received.

Patients were happy with the cleanliness of their rooms.Two of the patients we spoke with told us that staff had not always stayed with them when their medicines had been administered. Patients were happy that staff were competent to provide care that met their needs.

We found that before patients received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We also found that patients experienced care, treatment and support that met their needs and protected their rights.

We found that patients were protected from the risk of infection. However, patients were not fully protected against the risks associated with medicines because medication was not always administered correctly.

We found that not all staff had received appropriate training. We also found that patients were not adequately protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.

1 November 2012

During a routine inspection

We spoke with three patients. They told us they had received sufficient information before consenting to treatment at the service. They also told us they were treated with dignity and respect and their privacy was maintained. They told us they were very pleased with the quality of the care provided by the service. One patient said, 'I've been treated better here than anywhere else I've been. Absolutely excellent, I couldn't fault the care and attention.' Another patient said, 'It's always very good here.'

Patients told us they felt safe using the service and staff appeared well trained and competent. Patients knew what to do if they needed to make a complaint and staff knew how to manage this information appropriately. One staff member said, 'It is important to make sure the patients and their relatives are supported at all times.'

We found that patients were treated with dignity and respect and received care that met their needs. We found that patients were safe and the premises were safe.

We found that the provider took steps to assess the quality of the service being provided. However, we found that there was insufficient evidence to demonstrate that staff received induction, supervision, training and appraisal.

20, 21 March 2012

During a themed inspection looking at Termination of Pregnancy Services

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.