Nuffield Health The Manor Hospital Oxford is operated by Nuffield Health Group. The hospital facilities include 25 consulting rooms, six surgical theatres, 71 private en-suite bedrooms, two minor procedure suites for day case and outpatient surgery, and a radiology unit including: mammography, ultrasound, MRI & CT scans. There was also a seven bedded critical care unit and a physiotherapy department;
Nuffield Health The Manor Hospital Oxford is operated by Nuffield Health Group. The hospital facilities include 25 consulting rooms, six surgical theatres, 71 private en suite bedrooms, two minor procedure suites for day case and outpatient surgery, and a radiology unit including: mammography, ultrasound, MRI & CT scans. There was also a seven bedded critical care unit and a physiotherapy departmen; and two intervention suites for radiology and cardiology. The children and young people’s inpatient service had six single en suite rooms in one dedicated area.
The hospital provides surgery, medical care, critical care, services for children and young people, and outpatients and diagnostic imaging.
The hospital is currently registered for the regulated activities surgical procedures, diagnostic and screening procedures, and treatment of disease, disorder or injury.
We inspected critical care services and services for children and young people. We inspected the services using our focused inspection methodology to assess if improvements had been made in children services, and to inspect the critical care service as the hospital was not providing the service at our last inspection. We carried out the unannounced inspection on 30 August 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.
During the inspection, we visited the children’s ward, theatres and recovery, and the outpatient department. We spoke with eight members of staff including registered children nurses, registered general nurses, reception staff, medical staff, operating department practitioners and senior managers. We spoke with three patients and three parents. We reviewed 10 sets of patient records. Following our inspection, we had telephone conversations with parents of three children who had attended the hospital in the previous 12 months.
We also visited the critical care unit. We spoke with six members of staff including registered nurses, medical staff, and senior managers. At the time of the inspection there were no patients in the hospital who had used the critical care unit. Following our inspection, we had telephone conversations with five patients or their partners who had been in the unit within the last six months.
The children and young people’s inpatient service had six single en-suite rooms in one dedicated area.
The hospital provides surgery, medical care, critical care, services for children and young people, outpatients and diagnostic imaging.
The hospital is currently registered for the regulated activities surgical procedures, diagnostic and screening procedures, and treatment of disease, disorder or injury.
We inspected critical care services and services for children and young people. We inspected the services using our focused inspection methodology to assess if improvements had been made in children services, and to inspect the critical care service as the hospital was not providing the service at our last inspection. We carried out the unannounced inspection on 30 August 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.
During the inspection, we visited the children’s ward, theatres and recovery, and the outpatient department. We spoke with eight members of staff including registered children nurses, registered general nurses, reception staff, medical staff, operating department practitioners and senior managers. We spoke with three patients and three parents. We reviewed 10 sets of patient records. Following our inspection, we had telephone conversations with parents of three children who had attended the hospital in the previous 12 months.
We also visited the critical care unit. We spoke with six members of staff including registered nurses, medical staff, and senior managers. At the time of the inspection there were no patients in the hospital who had used the critical care unit. Following our inspection, we had telephone conversations with five patients or their partners who had been in the unit within the last six months.
Services we rate
Our rating of children’s service improved from requires improvement to good.
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Staff understood how to protect patients from abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
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The service had enough staff with relevant skills, training and experience to deliver safe care to children and young people.
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The service considered and took actions to lesson risks to children and young people.
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The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
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The service followed best practice when prescribing, giving recording and storing medicines.
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The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.
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The service provided care and treatment based on national guidance and monitored the effectiveness of care and treatment via audits. Findings were used to improve the services.
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The service assessed and monitored patients pain appropriately.
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Consent to care and treatment was obtained in line with national guidance.
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Staff cared for children, young people and their families with compassion. Feedback from patients and their parents was positive about the way staff treated them. The emotional needs of children, young people and their parents were fully considered.
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Staff involved children, young people and their patients in decisions about care and treatment.
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The service was planned around meeting the needs of the local population, with appointments and admissions offered to meet the individual circumstances of each patient.
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There was clear leadership of the children and young people’s service. A lead nurse had responsibility and accountability for all the children and young people’s services in the hospital. There was identified medical leadership.
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Governance processes supported improvement to the service.
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There was an inclusive culture, with staff of all professions across the hospital working together to deliver quality care to children and young people.
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There were processes for children, young people and their parents to feedback about their experiences of care and treatment at the hospital. Staff acted on this feedback to help plan and develop its service.
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The service was committed to improving services by learning from when things went well and when they went wrong.
However,
We rated the critical services as good.
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Systems and processes were in place and followed by staff to keep critical care unit (CCU) patients safe.
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There were sufficient numbers of staff with relevant skills and experience and up to date mandatory training in safety systems, processes and practices to deliver safe care to patients on the CCU.
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There was a good track record on safety and staff understood their responsibilities to raise concerns and incidents.
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Care and treatment was delivered in line with current evidence based guidance and standards.
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The service monitored the effectiveness of care and treatment via audits and used the findings to improve the services.
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Staff cared for patients in CCU and their families with care and compassion. Staff in the CCU involved their patients in decisions about care and treatment.
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The CCU service was planned around meeting the needs of the local population, with appointments and admissions offered to meet the individual circumstances of each patient.
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There was clear leadership of the CCU; and a lead nurse had responsibility and accountability for the CCU. There was identified medical leadership in the CCU.
Following this inspection, we told the provider that it must take some actions 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 children’s services. Details are at the end of the report.
Dr Nigel Acheson
Deputy Chief Inspector of Hospitals (London and the South)