Claremont Hospital is operated by Aspen Healthcare Limited. Claremont Hospital has 42 beds, three laminar flow theatres, 13 consulting rooms, a static MRI and CT scanner, and plain and digital X-ray. The hospital provides surgery and outpatients with diagnostic imaging services and we inspected both of these services.

We inspected this hospital using our comprehensive inspection methodology. We carried out the announced part of the inspection on 20 to 21 February 2017 with an unannounced visit to the hospital on 3 March 2017.

We rated the hospital as outstanding overall, with surgery rated as outstanding and outpatients and diagnostics rated as good.

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 services provided by this hospital were surgery, outpatients and diagnostics. 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.

We rated this hospital as outstanding overall because:

• We saw excellent leadership from managers who were passionate about patient care and staff welfare. They were visible to all levels of staff and patients.

• There were robust governance structures and reporting mechanisms in place where performance and the quality of the service was reviewed and changes made. Actions were monitored through audit processes and reported to leadership and governance committees.

• We saw a service wide vision and strategy that was embedded across the organisation.

• Patient care was at the heart of the service and the priority for staff. We saw several areas of outstanding caring practice.

• Staff were trained in a nationally recognised accreditation programme in customer care. Following this staff completed a Values Partners programme which is a workshop to explore values and behaviours between staff and towards patients and aims to create a positive working culture.

• The hospital took part in a recognised comprehensive observational study process to consider the approach by staff to the general care of patients, the level of patient/visitor engagement, and the environmental factors within patient reception areas. We saw an example of one survey in July 2016 and there had been an overall high score of 97%.

• There were effective systems to keep people safe and to learn from critical incidents.

• The hospital environment was visibly clean and there were measures to prevent the spread of infection.

• There were adequate numbers of suitably qualified, skilled, and experienced staff (including doctors and nurses) to meet patients’ need.

• There were arrangements to ensure staff had and maintained the skills required to do their jobs.

• There were arrangements to ensure people received adequate food and drink that met their needs and preferences.

• Care was delivered in line with national guidance and the outcomes for patients were good when benchmarked.

• Robust arrangements for obtaining consent ensured legal requirements and national guidance were met.

• The individual needs of patients were met including those in vulnerable circumstances, such as those with a learning disability or dementia.

• Patients could access care when they needed it.

However:

• We observed some environmental concerns in theatre areas. There was a refurbishment plan in place.

• Surgical safety checklists were not completed consistently.

• Not all checks had been completed in theatre for controlled drugs, drug fridges and warming cabinets. Some cleaning checks in the theatre areas had not always been completed daily.

• Not all eligible staff had received an appropriate level of safeguarding training to allow them to recognise any issues of concern.

• Mandatory training figures did not reach Aspen Healthcare Ltd targets.

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.

Ted Baker

Chief Inspector of Hospitals