Vision of Hope

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support.

This is the first assessment of this service since CQC introduced ratings.This key question has been rated as good.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service carried out a detailed assessment of people’s needs and documented this in the person’s clinical record. Records we reviewed as part of this assessment showed people were involved in assessments of their needs and goals. People we spoke with commented positively on the comprehensive nature of their initial consultation.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. It did this in line with legislation but there were gaps in the way this was managed.

The service provided was holistic and included evidence-based guidance on diet and other lifestyle factors. The underlying ‘treatment protocol’ which had been developed in the United States is not recognised as evidence-based by the UK National Institute of Health and Care Excellence (NICE) but is a novel, complementary approach. (A treatment protocol is a written, step-by-step plan that guides healthcare providers on how to diagnose, manage, and treat a specific medical condition or implement a specific medical intervention.) Some people told us they had specifically sought a service that provided this particular protocol-based therapy.

The clinic did not provide us with written treatment protocols for intravenous vitamin C infusion, medicines prescribed off-label or nutritional supplements. We were told that the dose of vitamin C being used depended upon the response from the patient with ‘tiredness’ being the main limiting factorin escalating the dose to the maximum.

However, the provider was able to verbally articulate the clinical checks, such as recent blood test results, that they required before initiating certain treatments. For example, people with poor kidney function were not eligible for high-dose vitamin C infusion. We saw evidence of these checks in the clinical records.

The provider was clear with people that they should continue with evidence-based primary treatments as guided by their oncology professionals, alongside any complementary treatment or therapy provided by the service. This advice was included in writing when the person was accepted for treatment by the service.

The service worked well across teams and services when appropriate.

The provider had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The service worked with other services, for example, communicating with people’s NHS GP when appropriate and if people consented. The service was able to direct people to diagnostic services (for example, for blood tests) and signposted people to other services, for example an independent dietitian, dispensing pharmacy and counselling services.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service provided lifestyle and preventative advice to people, for example, dietary advice and emotional support. People told us they valued this aspect of the service which was detailed and personalised.

The service did not always routinely monitor people’s care and treatment to continuously improve it.

The service did not carry out any more systematic audits or reviews of outcomes or other measures of quality of care or adherence to the treatment protocol. However, they gathered feedback from people individually to monitor their outcomes.

The service did not ensure consent to individual treatments was documented in sufficient detail. However, they told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service was not documenting people’s explicit consent for specific treatments. While, people told us the risks of specific treatments had been explained, and they had been asked for consent, this had not been documented in the clinical records. However, the service understood and applied legislation relating to consent and this was recorded. The service used written general consent forms when people were accepted for treatment at the clinic.

The provider had completed training on their roles and responsibilities under the Mental Capacity Act (2005), but this had been completed over 3 years ago.