Archived: Orwell Cardiothoracic Private Patient Unit

Updated 2 December 2016

Orwell Cardiothoracic Private Patient Unit is operated by Ramsay Health Care UK Operations Limited. The Orwell Cardiothoracic Private Patient Unit is a private patient facility situated within the Essex Cardiothoracic Centre located at Basildon University Hospital. The unit is a dedicated facility managed and staffed by Ramsay Health Care. The unit opened in May 2008 and consists of eight single rooms with en-suite facilities.

The unit admits a mixture of interventional cardiology and cardiothoracic patients, including angiography, angioplasty, electro physiological cases, ablation and pacemaker/defibrillator insertion. The unit also undertakes cardiac and thoracic surgical cases. Cardiac surgical procedures include valve replacement or repairs, coronary artery bypass grafting and thoracic aneurysm repair. Thoracic surgery undertaken includes lobectomy, thoracotomies, pleurectomies and bullectomies as well as a range of other pulmonary procedures.

The hospital has had a registered manager, who has been in post since June 2008.

This was the first inspection using the CQC’s power to rate independent healthcare services. The announced part of the inspection took place on 23 August 2016, and the unannounced inspection took place during the evening of 30 August 2016.

Updated 2 December 2016

Orwell Cardiothoracic Private Patient Unit is operated by Ramsay Health Care UK Operations Limited. The service has eight beds and provides level two care to patients following surgery. All surgical procedures, intensive care and high dependency care is provided by the NHS trust working in the Essex Cardiothoracic Centre. There are service level agreements in place between the Ramsay Healthcare service and the NHS trust to provide these services as well as medical staff cover where required.

The service provides surgery services for patients with cardiothoracic conditions. We inspected surgery as part of this inspection.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 23 August 2016, along with an unannounced visit to the hospital on 30 August 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.

Services we rate

We rated this service as good overall. We found the following in relation to surgery:

• There were good incident reporting, investigation and feedback systems. There was evidence of learning from incidents and changes to clinical practice to improve patient safety.
• The unit had good processes in place to monitor how safe it was by using its own clinical dashboard and quarterly audit tool.
• Infection control procedures were in place.
• National Early Warning Scores (NEWS) were being used which helped staff to recognise, respond to and escalate patient deterioration and risk.
• Policies and procedures were developed taking into account relevant national best practice guidance including those issued by the National Institute for Clinical Excellence (NICE) and relevant royal colleges such as The Royal College of Nursing (RCN).
• Staff were seen to provide compassionate, kind and dignified care. Patients said they were happy with the care they had received and felt cared for and listened to by staff. Patients felt involved in the decision making processes around their care needs and, where appropriate, staff involved and listened to patients’ family and friends.
• Systems and processes were in place to ensure care and treatment was tailored to meet the needs of different people. Staff ensured that patients received relevant information so that they could make an informed decision about their treatment.
• The unit had a clear vision and set of values in place and staff were aware of these.
• There was an effective governance structure in place and learning and improvement from incidents, complaints and audit outcomes was evident.
• Where we raised concerns, the management team took appropriate action promptly to resolve the issues. This included ensuring that the night shift was appropriately staffed.

However we also found:

• At the time of our inspection, there was no documented evidence of local induction for agency staff. We were told by the management team that they were in the process of designing an induction checklist for use with agency staff; however this was not yet in place.
• Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards knowledge amongst nursing staff was limited and none could give appropriate examples of the practical application of the MCA or of Deprivation of Liberty Safeguards.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 2 December 2016

We rated surgery services at Orwell Cardiothoracic Private Patient Unit as good. All domains were rated as good.

There were good incident reporting, investigation and feedback systems. There was evidence of learning from incidents. The unit had good processes in place to monitor how safe it was by using its own clinical dashboard and quarterly audit tool. Policies and procedures were developed taking into account relevant national best practice guidance. Staff were seen to provide compassionate, kind and dignified care. Systems and processes were in place to ensure care and treatment was tailored to meet the needs of different people. The unit had a clear vision and set of values in place and staff were aware of these. Where we raised concerns, the management team took appropriate action promptly to resolve the issues.

However, Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards knowledge amongst nursing staff was limited and should be improved. The provider should embed induction processes for bank and agency staff.