People we spoke with said they felt fully informed about their care and treatment. They had been able to ask questions and gain written information about their condition. A person we spoke with said “I have always received the most detailed of explanations. Everyone is very explicit.” This ensured people felt fully informed.

We saw that people received appropriate the care and treatment from suitably qualified and skilled staff. Care records we looked at were detailed and had been kept up to date. This ensured that people’s needs were known and could be met. A person we spoke with said “Staff are here as soon as I press my buzzer. The physiotherapist is very good. I am very happy with how things are.” Another person said “I cannot fault the care. The staff know my need well.”

People’s nutritional needs were assessed and were monitored. There was a choice of food provided which looked appetising and nutritious. One person said “The food is good. I chose from the menu. You can have whatever you fancy. I am spoilt for choice.” We saw that people’s dietary needs were being met.

Effective recruitment procedures were in place. There were enough skilled and experienced staff in place to care for people. A member of staff said " The recruitment process was thorough and fair."

The quality of the service provided was being monitored by the management team. Any issues found were acted upon to ensure people remained satisfied with the service they received.

People we spoke with told us that they had been given information which allowed them to consent to their care and treatment. One person said “I was examined and my procedure was explained. I was told to go away and think about my options. I saw my consultant and asked questions. I was happy to sign my consent form.”

People told us that they had received care and treatment that met their needs. One person said "I was exceptionally well looked after from the moment I came.” Another person said “Staff have had training in pre operative and post operative care so they understand my needs.”

We saw that there was enough staff to help and support people. Staff confirmed they had the right skills to meet people’s needs and said there were enough of them to provide care in a timely way. One person we spoke with said "There are masses of staff to meet my needs. They seem very professional.”

There were policies and procedures in place to help to protect people from abuse. We were informed that any issues raised would be offered to the local authorities safeguarding team. This helped to protect people.

People's views were sought about the service that was provided. A person we spoke with “I would raise issues, I would not hold back but everything has been okay.” We saw evidence that issues raised were acted upon to ensure people remained happy with the service they received.

During our inspection visit conducted 12 December 2011 we talked to patients who had just undergone a surgical procedure. Patients told us they had been well informed and felt they had received good care and had been happy their experience at the hospital.

“The consultant went through all the treatment options, I felt I was given all the options open to me, I felt I had time to consider my treatment options and I could ask questions”;

“I was happy to sign my consent for the procedure I have had, I was told of all the benefits as well as risks”;

“Post operative care 10 out of 10, it has been excellent. Staff have treated me with respect and knock on my door…Staff have been wonderful, I’ve been in a few hospitals over the years and this is the best”;

“The nursing care has been superb, staff are friendly and helpful”;

“My privacy and dignity has been respected by all staff”;

“I’ve found things excellent!”

“The staff are absolutely brilliant”;

“I’m very happy with the care I received”;

“Everyone is so friendly…all the staff including reception want to help…put me at ease”.

Nuffield Health York Hospital is operated by Nuffield Health. The hospital has 40 beds and facilities include three operating theatres (two of which have laminar flow), a surgical unit for ambulatory care, radiology, outpatient and diagnostic facilities. 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 the 6th and 7th September 2016 with an unannounced visit to the hospital on 13th September 2016.

We rated both core services and the hospital as good overall.

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 because:

• There were systems and processes in place to promote practices that protected patients from the risk of harm. Openness and transparency about safety were encouraged. When something went wrong, people received an explanation, and a sincere and timely apology.
• There were sufficient and appropriately qualified and experienced staff working in all departments to meet the needs of patients. We saw that equipment in all areas was well maintained and kept clean to minimise the risk of infection. Staff were able to respond to signs of a deteriorating patient and medical emergencies.
• Patient feedback demonstrated that staff strived to make the patient experience as positive as possible. Staff recognised and responded to the individual needs of their patients throughout the patient journey.
• The hospital had systems in place to provide care and treatment in line with national guidance. There was effective multi-disciplinary working and good communication between teams within the hospital and with external healthcare partners.
• There was a stable leadership team who were highly regarded by staff. Staff felt proud to work within the hospital and were very positive about the culture and the quality of teamwork.
• There was a clear governance structure and a comprehensive reporting framework in place that provided timely information to the hospital board, medical advisory committee and to the corporate team.

We found areas of practice that required improvement in both surgery and outpatients services.

• We did not identify a clear mechanism to share learning from unplanned transfers and patient safety incidents with the Resident Medical; Officer. This was acted upon at the time of inspection and at the unannounced inspection, communication systems had been improved.

In surgery:

• None of the ten surgical case notes reviewed for consultant entries recorded daily consultant visits as per the requirements of practising privileges. Two sets of notes had documentation about the consultant’s visit from the nurse in charge of the patient’s care.
• Two patients receiving oxygen did not have oxygen prescribed on the medication record. This was raised at the time of inspection and immediately actioned.

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.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North Region)