Holy Cross Hospital

Updated 26 June 2017

Holy Cross Hospital is one of the works of the charity, The Congregation of the Daughters of the Cross of Liege.

In 1917, the Congregation relocated a sanatorium from Ramsgate, Kent to Haslemere, Surrey. From the 1950’s onward, the sanatorium was adapted to undertake a range of medical and surgical work, mostly through contractual arrangements with NHS bodies. By the 1980’s the hospital focussed on the treatment and care of severely physically disabled adults. In 1992 a new hospital was built by the Congregation to provide specifically designed facilities to manage patients with complex neurological disorders.

The hospital has admitted patients requiring specialised respiratory support for tracheostomy and ventilator management since the 1980’s and in 2009 they added a new building, the Physiotherapy Centre, to provide hydrotherapy for in and outpatients. At the time of inspection, the charity was funding a new Education Centre to support staff learning and development.

On the ground floor of the hospital there is a ward with 20 beds, all in single rooms with ensuite toilet facilities, there is also the reception, chapel, quiet room and offices and the hydrotherapy suite. On the first floor, there is another ward of 20 beds in single rooms with ensuite toilets, as well as an inpatient physiotherapy gym, living room, sensory technology room and an outpatient physiotherapy gym and consulting room.

The hospital is registered to provide the following regulated activities:

• Diagnostic and screening procedures

• Treatment of disease, disorder or injury

Updated 26 June 2017

Holy Cross Hospital is operated by The Congregation of the Daughters of the Cross of Liège. The hospital has 40 inpatient beds. Facilities include: 40 single bedrooms with ensuite and overhead hoists, an inpatient physiotherapy gym and a separate Physiotherapy Centre for outpatients, a hydrotherapy pool with hoist to assist transfers, a sensory room, an activity room with a therapy kitchen, a sensory garden, and a woodland trail. At the time of inspection, the hospital was in the process of building an Education Centre.

The hospital provides support for patients with long-term conditions within the specialisms of: disorders of consciousness; postural and physical management; complex respiratory management; swallowing disorders and nutrition as well as providing assistive technology.

Physiotherapy services are provided to outpatients at the integrated physiotherapy centre, as well as the gym and hydrotherapy pool.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 28 and 29 March 2017.

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.

We rated this hospital as outstanding overall. We rated safe, effective and well led as good and responsiveness and caring as outstanding.

We found areas of outstanding practice:

• Patients were truly respected and valued as individuals an there was an emphasis on providing a care setting that patients could consider their home.There was an embedded culture of caring amongst all staff and we saw many examples of staff going the ‘extra mile’ to meet the needs of patients in ways that took account of their personal preferences. This included personal, cultural, social and religious needs.

• The hospital was at the forefront of care for people with long-term conditions. There was holistic approach to assessing, planning and delivering care and treatment to people who use services. The safe use of innovative and pioneering approaches to care and how it is delivered were actively encouraged. New evidence-based techniques and technologies were used to support the delivery of high quality care. Staff from the hospital had been invited to co-write Royal College of Physicians (RCP) guidelines regarding pain as well as to set up a patient group as part of a centre of excellence.

• When patients needed acute hospital care, there were arrangements for staff from Holy Cross Hospital to support patients in this environment, and also to support other professional staff in meeting the complex, individual needs of patients. Patients were welcomed when they returned. 

• Services were tailored to meet the needs of individual patients whose needs and preferences are central to the planning and delivery of tailored services. The services were flexible, provided choice and ensured continuity of care.  There were opportunities for patients and those close to them to experience a range of environments. There was a woodland trail outside the hospital that was wheelchair friendly and provided views over the countryside, a sensory garden included a fishpond with waterfall, plants of varying colour and scent and a terrace. Patients also had access to a holiday cottage in Selsey.

• The hospital had established “Special Interest Groups” covering a range of clinical areas such as infection prevention and control to ensure best practice and guidance was reviewed, considered, disseminated and managed throughout the hospital.

We found other areas of good practice.

• People were protected from avoidable harm and abuse.

• There were systems to report and investigate incidents, to control the spread of infection, to manage medicines in line with legislation and current guidelines and to report and investigate suspected abuse.

• There were sufficient numbers of staff with the necessary qualifications, skills and experience to meet patient’ complex needs.

• The leadership, governance and culture promoted the delivery of high quality person-centred care.

However, we also found the following issues that the service provider needs to improve. The hospital should:

• Expand information on duty of candour in the incident policy to indicate the practical application of candour as a point of reference for all staff.

• Have an auditable target in place for mandatory training completion.

• Follow through the chain of disposal external to the hospital for assurance at least annually.

• Document a rolling schedule of planned preventative maintenance for equipment used to enable easy reference.

• Conduct additional resuscitation scenario training.

• Establish key performance indicators within the pathology service level agreement setting out reporting.

• Review its arrangements for advanced care planning.

• Review the use of syringe drivers to support patients on an end of life pathway and to provide medication where appropriate.

• Ensure all staff have an annual appraisal.

• Ensure all staff know how to access professional translation services.

• Devise a risk register that is prioritised and gives the management team assurance of safety across the organisation.

Professor Ted baker

Deputy Chief Inspector of Hospitals

Updated 26 June 2017

Patients were protected from avoidable harm and abuse as there were systems to report and investigate safety incidents and learn from them. The hospital was visibly clean and well maintained and the risk of infection was controlled. Medicines were managed in line with current best practice and legislation. There were sufficient numbers of staff with the right skills to meet the needs of patients. The multi-disciplinary team worked effectively together. Care was delivered in line with national and international guidelines and practice was actively monitored and reviewed. There were arrangements to ensure patients’ nutritional needs were met and any pain they experienced was managed. Where patients lacked capacity to consent, staff acted in accordance with the Mental Capacity Act 2005. We saw outstanding examples of care being organised and delivered with compassion. There was a focus on protecting rights and dignity of patients and those close to them and they were fully involved in decisions about care. Patients’ individual needs and preferences were central to the planning and delivery of tailored services. Services were provided to support the holistic needs of patients. There were processes to receive, review and learn from feedback including complaints. The hospital had a clear set of values well understood and demonstrated by staff, who showed high levels of satisfaction with their work.