Nuffield Health Woking Hospital has 26 beds and is operated by Nuffield Health. Facilities include two operating theatres, a ward that provides level one care, outpatient and diagnostic facilities. The Nuffield Health Woking Hospital provides surgery, outpatients, and diagnostic imaging.

We visited this hospital in November 2016 as part of our national programme to inspect and rate all independent healthcare providers.

While we rated both core services and the hospital as ‘good’ overall, we found improvements were required to minimise risks and promote safety. We told the hospital it must:

• Maintain securely an accurate, complete and contemporaneous record in respect of each service user, including a record of the care and treatment provided to the service user and of decisions taken in relation to the care and treatment provided This was because copies of the consultant’s individual notes for private patients in the outpatient department were not kept by the hospital; these were kept by the individual consultants. The hospital had a record of the original referral and copies of diagnostic treatments performed only.

We told the hospital that it must give us an action plan showing how it would bring services into line with the regulations. The hospital provided a plan.

At this announced inspection, we focused on the action plan and found that the hospital was not yet compliant but had taken action to improve. The hospital had taken action to comply with the regulation and:

• Were working with the consultant medical staff to improve record keeping within the outpatient department.

• Had put systems in place to improve and audit compliance.

We will continue to monitor the performance of this service and inspect it again, as part of our ongoing programme.

Professor Edward Baker

Deputy Chief Inspector of Hospitals (South East)

We carried out an inspection at Nuffield Health Woking Hospital to look at the care and welfare of patients who used the service.

As part of our inspection we spoke to two patients, seven members of staff and collected surveys from eleven patients who were attending outpatient services.

The survey results showed us that people rated the service either ‘good’ or ‘excellent’. And we were told by one patient we spoke with that staff were “Nice, personable, polite and considerate.”

We noted during our inspection that patients were asked for their consent to treatment. The staff that we interviewed told us the ways in which they ensured that patients understood what they were consenting to.

We talked to the catering staff on the day and saw examples of the food that was on offer to people. When we asked people’s opinions on the quality of the food we were told “The choice is good” and “Good quality.”

We saw that the provider had robust recruitment processes in place and that they ensured that only suitable and qualified staff were employed.

We observed that people had access to information on how to make a complaint should they wish to. The people that we spoke with on the day told us they could approach the staff if they were unhappy about anything.

During our inspection we spoke with two patients and collected surveys from seven patients who were attending outpatient services. We spoke with four staff, visited the in patient unit and looked at care records and other documents. We made observations throughout our visit.

Patients were positive about the service and were unanimous that they were treated with respect and involved in their care. From survey results and talking with patients we found that staff were considered to have been consistently polite and helpful, well trained and professional.

Medicines management procedures were in place and each patient we asked told us that they were able to get help and advice with their medication if they needed to. However, we saw that one patient did not have their medicines stored securely which was not in line with the hospitals procedure.

Patients were positive about the staff and the overall quality of the service. Most told us that the quality of care was either very good or excellent. One patient told us that staff were “Very professional and provide excellent care.” Another told us that staff "Take time to explain things fully.”

Patients were mainly protected from the risks of unsafe care through accurate record keeping. However, during our review of care plan documentation, we found one example where care had been given but had not been accurately recorded.

People using the services of the hospital told us that they had received a very good level of service, and a good experience. The staff were described as being very nice and friendly. They were reported to respond promptly to requests and provide information and explanations or answers to any questions. Meals were found to be well presented and lovely, with a good selection and choice.

Nuffield Health Woking Hospital is operated by Nuffield Health. The hospital has 26 beds. Facilities include two operating theatres, a ward that provides level one care, and X-ray, outpatient and diagnostic facilities.

The Nuffield Health Woking Hospital provides surgery and outpatients and diagnostic imaging. We inspected both of these core services.

We inspected this service using our comprehensive inspection methodology. We carried out announced inspection on the 8 and 9 November 2016.

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.

Services we rate

We rated this hospital as good overall.

We found good practice in relation to outpatient and surgical care:

• There were arrangements to report and investigate any critical incidents and to learn from these.

• Risks were identified and managed to minimise the risk of harm to patients and others.

• Patients were cared for in a clean and hygienic environment and there were systems to prevent and control the risk of infection. The environment was safe and generally fit for purpose. There was adequate equipment available which was well maintained.

• There were adequate numbers of staff with the skills experience and qualifications to meet patients’ needs. They were competent to do their jobs and were supported in developing their skills.

• Care was delivered in line with national guidelines and patients experienced good clinical outcomes.

• Patients’ pain was well managed.

• Patients received adequate food and drink that met their needs and were not fasted for longer than necessary.

• Patients were treated with dignity and respect, and were involved in planning their care. There were arrangements to ensure that individual’s needs were met.

• Patients could access care and treatment when they needed it without undue. They could access treatment by a full range of health professionals and there were arrangements to ensure safe care both in and out of hours. Discharge procedures ensured continuity of care with patients GP’s or other health care professionals.

• Complaints were well managed and comments were used to improve the service.

• There was a well understood vision, values and strategy for the service which prioritised safe care.

• There were robust governance systems that ensured the leadership team were assured of the quality and safety of the service.

• Staff felt well supported by the leadership team who were approachable and highly visible. They felt involved in the ongoing development of the hospital.

However, in out-patients we also found the following issues that the service provider needs to improve:

• The keeping of an accurate, complete and contemporaneous record in respect of each patient.

Following this inspection, we told the provider that it must take one action to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected outpatient and diagnostic services. Details are at the end of the report.

Professor Edward Baker

Deputy Chief Inspector of Hospitals (South)