The people we spoke with were mostly positive about their care and treatment at the hospital. One person said, “My overall care has been extremely good.” Another told us, “I know what’s going to happen at each appointment.”

There were appropriate arrangements in place to ensure patients’ consent before treatment. Patients we spoke with felt staff took the time to discuss and explain their diagnosis and treatment and felt involved in decisions about this. One person said, “The discussion is never one sided.”

There were enough qualified, skilled and experienced staff to meet people’s needs. One patient we spoke with said, “I have never felt that there are not enough staff and have never had to wait long for staff to come to provide care and support.” Another patient said, “Staff always respond when I press my bell.”

Staff received appropriate training, professional development, appraisal and supervision and were supported in their roles.

We found that people’s care, treatment and support needs were met in most respects and we observed staff interacting positively with them in a caring and responsive manner.

However, we found some shortcomings in the care and welfare of people using the services, the safety and suitability of premises and in assessing and monitoring the quality of service provision

Patients we spoke with that were privately funded consistently confirmed that they had clear and timely information about all associated costs with their treatment.

There were various arrangements in place to accommodate people's needs, values and diversity such as wheelchair access and special dietary options.

Patients confirmed that the hospital had worked with their other care providers to make sure they were properly cared for.

Our inspection of 31 January 2012 found that the hospital equipment had not been properly maintained. When we inspected on 30 October 2012, we found that equipment was properly maintained and suitable for its purpose.

Members of staff received professional training and development, and felt supported by their colleagues.

The provider took account of complaints and comments to improve the service. Patients were encouraged to complete feedback forms prior to their discharge from the hospital, and this information was reviewed and shared with the staff team.

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.

People said that they had been well cared for by staff. They said that staff always introduced themselves and were kind and sympathetic. The people we spoke with were positive about the care that they had received.

They also said that they felt fully informed about the care and treatment that was being provided to them. They said that their care and treatment and the possible risks were explained to them in detail prior to being admitted to the hospital. They said that this was outlined again by the consultant before any procedure was carried out.

People said that they were made aware of how to make comments about the care and treatment the hospital provided to them. The people we spoke with did not have any concerns about the way they had been cared for or treated.

BMI The Blackheath Hospital is an acute independent hospital that provides outpatient, day care and inpatient services. A range of services such as physiotherapy and medical imaging are available on site. The hospital offers a range of surgical procedures and cancer care as well as rapid access to assessment and investigation and level 2 critical care. Services are available to people with private or corporate health insurance or to those paying for one off treatment. The hospital also offers services to NHS patients on behalf of the NHS through local contractual arrangements.

The hospital provides surgery, services for children and young people, outpatients and diagnostic imaging. We inspected only surgical services at this inspection.

We inspected this service using our focussed inspection methodology to follow up on a requirement notice issued following a comprehensive inspection of the hospital in July 2016. This inspection was unannounced and our visit to the hospital took place on 15 January 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?
• Are they effective?
• Are they caring?
• Are they responsive to people's needs?
• Are they 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.

During the inspection, we visited two wards, three theatres and a two-bedded high dependency unit. We spoke with 18 staff including registered nurses, health care assistants, reception staff, medical staff, operating department practitioners, and senior managers. We spoke with nine patients and two carers. During our inspection, we reviewed 11 sets of patient records.

There were no special reviews or investigations of the hospital ongoing by the CQC at any time of or during the 12 months prior to this inspection. The hospital has been inspected two times previously and the most recent inspection, prior to this one, took place in July 2016. At the July 2016 inspection, we found that the hospital was meeting all standards of quality and safety it was inspected against except regulation 12 Safe, care and treatment. This breach of regulation was due to poor decontamination practices in the endoscopy unit and the CQC issued a requirement notice for the hospital to take action. At this inspection, we found that this had improved since the last inspection and was no longer a breach in regulation. Please read the surgery report below for further details.

The hospital had an appropriately appointed registered manager who had started the role in October 2018.

Services we rate

Our rating of this hospital stayed the same. We rated it as Good overall.

We found good practice in relation to surgery:

• The service controlled infection risk well.
• The service had enough staff to provide the right care and treatment.
• The service made sure staff were competent for their roles.
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff cared for patients with compassion.
• The hospital planned and provided services in a way that met the needs of local people.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
• The hospital and wider organisation had a vision for what it wanted to achieve and workable plans to turn it into action.
• Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
• The hospital used a systematic approach to continually improving the quality of its services.
• The hospital had effective systems for identifying risks, planning to eliminate or reduce them.

We found areas of outstanding practice in surgery:

• Daily head of department meetings with the executive director and all head of departments had a unique multidisciplinary approach which enabled colloborative working, easy sharing of learning, escalation of concerns and cascading of information to departmental staff.
• Patients received interactive exercise information which included demonstrations videos to help with their recovery at home.

We found areas of practice that require improvement in surgery:

• The hospital should ensure it complies with its own target for mandatory training.
• The hospital should ensure there is an appropriate space to store used surgical equipment.
• The hospital should ensure all incidents are reported in a timely manner.
• The hospital should ensure they compare the difference in patient outcome measures scores (PROMS) between NHS and private patients.
• The hospital should ensure its promotes an inclusive culture with regard to patients with additional needs.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Edward Baker

Chief Inspector of Hospitals