During our visit to BMI The Meriden we spoke at length with six patients. We also spoke with one out-patient nurse and two nurses on the ward, a housekeeper, a chef, and five staff in management positions.

Procedures had been fully explained to patients and consent to treatment had asked for and given before treatment or surgery was conducted. We saw patients had received good care. Patients we spoke with said,

“No complaints, no problems, a joined- up service.”

“Very helpful…wonderful…a beacon of light.”

“The staff are absolutely lovely, they are so helpful.”

“Everyone is very attentive, nothing is too much trouble.”

“The nursing staff are brilliant.”

We looked at the menu provided to patients during their stay. All patients we spoke with told us how much they enjoyed the food provided to them.

We looked at the cleanliness of the hospital. We saw the hospital was clean and good systems were in place for infection prevention and control.

We looked at staff recruitment processes. We were satisfied the hospital employed staff who were suitably qualified. Pre-employment checks had been carried out to ensure staff were safe to work with patients.

We checked how the hospital managed complaints made by patients. We saw the hospital took complaints seriously and investigated complaints in a timely manner.

We saw the hospital worked well with other health care providers to ensure the health of patients was well supported.

The Meriden Hospital has one ward. We visited the ward and spoke with eight of the 26 patients. We pathway tracked four patients, which involved looking in detail at their experience of the care and support they received.

We spoke with eight members of staff. We looked at medical and nursing records. We also looked at some records relating to the management of the hospital such as staff duty rotas and personnel files, audits and quality reports.

Patients were positive about the care and treatment they had received at the hospital. Their comments included,

“It’s brilliant. It’s the best place to rest and recover.”

“I am well cared for. I asked for a cup of tea at 2am and was given it without a problem.”

“Everything is ok and they are co-operative.”

The patients we spoke with told us they had received relevant information about their treatment and progress.

Patients told us they were treated with dignity and respect.

We found that suitable equipment was available to support people’s needs.

Patients had the opportunity to provide feedback on their experience at the hospital and this information was analysed and used to improve services.

Some staff told us they were concerned that they did not get the support they needed to develop their knowledge and skills. We found that improvements were needed to give staff opportunities for training to make sure patients get the specialist care they need.

BMI The Meriden Hospital is operated by BMI Healthcare. The hospital is registered for 52 beds, 48 of which are on the inpatient ward, with a further four beds in the endoscopy suite. Facilities include three operating theatres, all with laminar flow, a dedicated endoscopy suite, cardiac catheter laboratory and outpatient and diagnostic facilities.

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

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 24 and 25 April 2018, along with an unannounced visit to the hospital on 2 May 2018.

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 core service.

See the surgery section for main findings.

Services we rate

We rated this hospital as good overall because:

• The hospital had systems and processes in place to protect patients from avoidable harm and abuse.

• The processes for reporting, investigating and learning from incidents were well established and implemented. This was an improvement from the last inspection in May 2016.

• Infection prevention and control practices were performed well, and staff followed hospital policies. The environment was clean and fit for purpose.

• Medicines were managed and stored correctly. This was an improvement from the last inspection in May 2016.

• Staff assessed risk to patients and responded appropriately when individual patient’s risks increased.

• The hospital participated in national audits where applicable. The hospital was fully engaged in the Private Healthcare Information Network (PHIN) work to develop outcome measures for independent healthcare patients.

• The hospital had a comprehensive internal audit programmes in place to monitor services and identify areas for improvement.

• Staff treated patients with care, kindness and compassion.

• Complaints and concerns were taken seriously, responded to in a timely way and managed with face to face meetings with the complainant where needed.

• Managers were visible, approachable and performed well.

• Staff we spoke with, enjoyed their work and were proud to work at the hospital. They described an open culture and felt supported and listened to by their immediate managers.

We found areas of good practice in relation to surgery:

• Patients had access to care and treatment in a timely way and cancellations to surgery were minimal.

• Patients were appropriately assessed prior to surgery and there were processes in place to transfer patients should they require a higher level of care.

• Comprehensive risk assessments were carried out for specific patient groups and risk management plans were developed in line with national guidance.

And some areas for improvement:

• During one medicines round a nurse did not follow one standard for administering medicines.

• Not all patient outcomes were measured for patients undergoing colonoscopies.

• There was only one toilet in the endoscopy unit, and patients were admitted in the cubicles where some information could be over heard by other patients.

• We found areas of good practice in relation to outpatient care:

• There were robust systems in place to ensure that patients and staff were protected by adherence to national guidelines relating to ionising radiation and diagnostic imaging.

• Patient care and treatment was delivered in line with national guidance.

And some areas for improvement:

• There were no patient leaflets in the diagnostic imaging department.

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. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals