Heatherwood Hospital

Updated 13 March 2019

The trust brought together Heatherwood and Wexham Park Hospitals NHS Foundation Trust and Frimley Park Hospital NHS Foundation Trust to create Frimley Health NHS Foundation Trust on 1 October 2014.

The trust is part of the Frimley Health and Care system, one of 14 integrated care systems (ICS) nationally.

Heatherwood Hospital has 34 inpatient beds and 24 day care beds providing elective surgery for orthopaedics, gynaecology, urology, breast surgery, oral and maxillofacial surgery and general surgery alongside a wide range of outpatient specialties and diagnostics. 

Heatherwood and Wexham Park Hospitals serve a population of around 435.000 people. 

Heatherwood Hospital has approximately 193 clinical staff based on site and around 30 doctors who are based at Wexham but provide clinical sessions on the Heatherwood site.

Many administrative functions with a total of about 335 staff are based at a dedicated block on the Heatherwood site and serves the whole trust.

This is the first time we have inspected this hospital as part of Frimely Health NHS Foundation Trust.

Updated 13 March 2019

The service was not previously inspected or rated as part of Frimley Health NHS Foundation Trust. We rated it them as good because:

• On this occasion we rated surgery as good in the key area of safe, effective, caring, responsive and well led.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
• The hospital controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection. The hospital had premised that were no longer fit for purpose and was planning a rebuild of the site. Meanwhile the premises were kept safe for use.
• The hospital followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right dose at the right time.
• The hospital had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• 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. When things went wrong, staff apologised and gave patients honest information and suitable support in line with the duty of candour.
• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance and monitored the effectiveness of care and treatment and used the findings to improve them.
• Staff gave patients enough food and drink to meet their needs and improve their health. The hospital made adjustments for patients’ religious, cultural and other preferences.
• Staff assessed and monitored patients regularly to see if they were in pain. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
• The trust planned and provided services in a way that met the needs of local people and took account of patients’ individual needs. The trust was a leader in the Frimley Integrated Care System and collaborated well with partners.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff. However, the trust did not always meet its own standard in response timeliness.
• Managers at all levels in the hospital had the right skills and abilities to run a service providing high-quality sustainable care.
• The trust had a vision for what it wanted to achieve and workable plans to turn it into action. This was underpinned by a set of values that staff at the hospital understood.

However:

• Although the trust provided mandatory training in key skills to all staff the trust was not achieving its completion target of 85% in all topics.
• Although there were systems for managers to appraise staff’s work performance not all staff had received an up to date appraisal.

Updated 13 March 2019

The service was not previously inspected or rated as part of Frimley Health NHS Foundation Trust. We rated it as good because:

• The service controlled infection risk well. The hospital was clean and well looked after despite the difficulties presented in maintaining an older building.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with staff to continuously improve patient safety.
• Staff maintained good record keeping standards. Staff kept records of patients’ care and treatment in line with Nursing and Midwifery Council and General Medical Council guidance. Records were clear, up-to-date and available to all staff providing care.
• The service used safety monitoring results well. Staff collected safety thermometer information, such as rates of falls, pressure ulcers and catheter-acquired urinary tract infections and shared it with staff, patients and visitors.
• The trust had effective processes for assessing and responding to patients at risk. The service carried out assessments of risks to patients and acted to lessen risks such as falls and pressure ulcers. We saw there were regular observations of patients using an early warning system and action taken to escalate any deterioration.
• Patients had good outcomes following surgery. Results from national audits showed the service performed well, with patient outcomes about the same as other NHS acute hospitals nationally.
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment. The service made sure staff were competent for their roles. Managers appraised staff performance, and we saw records of meaningful appraisals. Competency records we reviewed provided assurances staff had the skills they needed to do their jobs.
• Staff of different kinds worked together as a team to benefit patients. We saw positive examples of multidisciplinary working between different staff groups, including doctors, nurses and therapists.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
• Staff involved patients and those close to them in decisions about their care and treatment.
• Staff provided emotional support to patients to minimise their distress.
• Staff took account of patients’ individual needs. The service took action to meet the needs of different patient groups so they could access the service on an equal basis to others.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results. The service shared learning from complaints with relevant staff to help drive continuous improvement. However, they did not meet their own standards regarding the timeliness of complaint responses.
• Managers across the trust promoted a positive culture that supported and valued staff. Staff generally spoke positively of the culture and described positive working relationships with colleagues and managers