SpaMedica Sittingbourne

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that patients and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of patients and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that patients could access care in ways that met their personal circumstances and protected equality characteristics.

Staff involved patients, and where appropriate their families, in decisions about care and treatment and provided information in a way they could understand to support informed choices. The service sought and responded to patient feedback, and patients knew how to raise concerns. Care was well organised, with reasonable adjustments made to meet individual needs and reduce inequalities in access, experience and outcomes. Patients were also supported to understand their ongoing care and future treatment options.

This is the first assessment for this service. This key question has been rated good. This meant patients’ needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed a good standard. The service made usually sure patients were at the centre of their care and treatment choices and they decided, in partnership with patients, how to respond to any relevant changes in patient’s needs.

The service made sure patients were at the centre of their care and treatment choices and worked with them to respond to changes in their needs.

Access to the service was managed through a central booking system, helping ensure patients were offered appointments at the location most suitable for their needs. The service made reasonable adjustments where required so patients could access appropriate care and treatment. Patients were involved in planning their care and were encouraged to identify any support needs, such as mobility requirements, in advance of their appointment.

Managers organised services around patients' needs. Patients were referred through their GP or optometrist and received coordinated care throughout their treatment pathway. Post-operative assessments were provided by accredited optometrists at convenient locations, often allowing patients to be seen by their referring optician. Patients also had access to a helpline for advice and support following treatment, helping to ensure choice, flexibility and continuity of care.

In addition, patients could receive follow-up care through accredited optometrists at convenient locations, often with their referring optician. A sight support service was also available to provide practical and emotional support to people living with sight loss. Staff took time to understand patients' individual needs, preferences and circumstances and used this information to plan and deliver care. Communication needs were identified at an early stage and recorded so staff could make appropriate adjustments throughout the patient journey. Interpreters and other communication support were available when needed.

Patients were given a choice of food and drink to meet their cultural and religious preferences. The catering services adapted to the needs of the patients.

We reviewed 5 patient records and care plans to assess how staff gave choice and involved individuals in decisions Staff explained conditions, treatment options and associated risks and benefits in a way people could understand, enabling them to make informed choices.

Patients consistently described care as tailored to their individual circumstances and told us staff took time to understand and respond to their needs and preferences. Notice boards within the service had numerous cards thanking staff for the service they received. We saw positive feedback from 2 patients online via a well-known survey company and there was a booklet called “feeling the love” that contained thank you cards from patients.

The evidence showed a good standard. The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service provided care and treatment to patients that considered the diverse health and social care needs of their local communities. Staff supported local community initiatives and worked with external organisations where appropriate to improve care and patient experience

Care pathways were joined up, with effective communication between the service and community optometrists before and after surgery to support continuity of care. Staff worked closely with GPs, community optometrists and secondary care providers to ensure referral pathways were clear and patients experienced coordinated care.

Patients were able to access care closer to home where appropriate. Accredited optometrists provided pre-operative and post-operative care in community settings, often at the patient's usual optician. This reduced unnecessary travel and supported continuity of care.

The service offered flexible appointment times and contacted patients who missed appointments to rearrange their care and help prevent delays in treatment. Staff also made reasonable adjustments to meet individual needs and adapted care when patients’ circumstances changed.

Patients’ care and treatment was delivered in a way that met their assessed needs from services that were co-ordinated and responsive.

Staff also supported local community initiatives and worked with external organisations where appropriate to improve care and patient experience.

The evidence showed a good standard. The service usually supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service provided patients with clear, accurate and up-to-date information to support their care and treatment.

Information was available in a range of formats, including printed leaflets, display boards, electronic resources and information on the service's website. Leaflets were maintained electronically to ensure patients received the most up-to-date versions and could be printed on request. The service used black and yellow printed leaflets, which could be easier for some patients with visual impairments, including people with glaucoma, to read.

Interpreting services, including British Sign Language support, were available when required. Information was also available in different languages, and large-print displays were used throughout the clinic to support people with visual impairments.

The website included a virtual tour of the clinic and information about what to expect on the day of surgery. Patients also had access to information about procedures, aftercare, eye health and frequently asked questions through information boards located throughout the service.

Patients were kept informed about waiting times and any delays to appointments. Information about clinic activity, available services and support, including patient transport and wellbeing information, was clearly displayed throughout the clinic.

Staff were responsible for reviewing and updating patient information to ensure it remained accurate, relevant and accessible. Staff were aware of how to use and store confidential information. Staff had to complete mandatory information governance training 100% of staff had completed this.

The evidence showed a good standard. The service generally made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved patients in decisions about their care and told them what had changed as a result.

The service made it easy for patients to share feedback, raise concerns and be involved in decisions about their care, treatment and support. Staff involved patients in decisions about their care and worked to ensure treatment reflected their needs and preferences.

Patients were given opportunities to provide feedback through a range of accessible methods. Information about how to raise concerns or make a complaint was clearly displayed in patient areas and available on the provider's website. Patients told us they felt confident that concerns would be taken seriously and addressed appropriately.

The service used patient feedback to identify opportunities for improvement and make changes to enhance the patient experience. Learning from complaints and feedback was shared with staff and used to improve services. Staff viewed feedback as an opportunity to learn and improve the care provided.

The service also offered chaperones for examinations and procedures, and information about this was clearly displayed.

The service had a complaints policy and systems to investigate concerns thoroughly and respond in a timely way. The provider described systems for managing complaints, investigating concerns and sharing learning. However, the service did not provide us with information relating to complaints during the assessment.

Patients were supported with clear information about their care and were treated as partners in decision-making. They received a letter with details of the treatment they had undergone and left the service with written instructions on eye drop administration and self-care. Patients were also given information on how to contact the service if they had concerns, supporting continuity and ongoing care.

The evidence showed a good standard. The service usually made sure that patients could access the care, support and treatment they needed when they needed it.

People could access the service when they needed to and received the right care promptly. The service supported equitable access by offering patients a choice of appointment dates, providing reminders, and allowing appointments to be rescheduled easily when needed. Referrals were accepted from both opticians and GPs.

Managers monitored access to services and ensured patients received care within agreed timeframes. Patients were offered appointment choices, received appointment reminders and were supported to rearrange appointments where needed.

The service monitored referral to treatment (RTT) times to support timely access to care. At the time of inspection, the service reported an RTT time of 9.3 weeks, which was better than the NHS standard of 18 weeks. Leaders regularly reviewed performance and capacity to help ensure patients received treatment without unnecessary delay.

Staff assessed patients' communication, mobility and sensory needs before appointments and made reasonable adjustments where required. We heard an example of how the service had acted on feedback from a partially sighted person to improve accessibility within the environment and was exploring further improvements to accessible information for patients.

Patients could access support when they needed it, including a 24-hour advice line. Systems were in place to ensure patients requiring urgent advice or treatment received an appropriate response.

The service took steps to reduce barriers to accessing care by providing a free door-to-door transport service for eligible patients. Patients were required to be able to get on and off the vehicle independently, and transport could be arranged by taxi where needed. Carers or relatives could accompany patients, and drivers provided support to help patients attend their appointments.

Staff supported people with specific needs, including those living with dementia, learning disabilities or mental ill health. Quiet areas were available for patients who found busy waiting areas difficult, and staff used sensory resources and dementia-friendly information to support patients throughout their visit.

Leaders worked with community partners and local organisations to understand and respond to the needs of different groups within the community. The service promoted an inclusive environment and recognised the diverse needs of the communities it served. Meeting minutes showed an awareness of health inequalities and stated the service wished to trial an initiative to increase referrals from hard-to-reach communities and those in areas of deprivation and people whose cultural needs require support. However, it was not clear whether this had begun or what success had been achieved.

The evidence showed a good standard. Staff and leaders listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff and leaders listened to information about patients who were more likely to experience inequality in access, experience or outcomes and tailored care in response.

Staff identified patients who may require additional support through referral information, assessments and discussions during their care. This included people with sensory impairments, learning disabilities, neurodiversity, language barriers, mobility needs and social disadvantages. Staff used this information to make reasonable adjustments, adapt communication methods and arrange additional support where required. Staff are trained in equality, diversity, inclusion and human rights. Compliance for the surgery service was 100%.

People who did not speak English as their first language could access the service. Staff had access to interpret services by telephone. Interpreting services were available for patients whose first language was not English, and carers or advocates were involved where appropriate. Care records demonstrated that staff considered both clinical and social factors when planning treatment and follow-up care to support positive outcomes

Clinicians explained expected outcomes and, where necessary, reviewed treatment options over more than one appointment, allowing patients time to reflect on their choices. Staff also signposted patients to additional support services when required and ensured they understood how to access further advice if their circumstances changed.

Staff worked effectively as a multidisciplinary team throughout the patient journey. Optometrists, nurses and surgeons worked together to ensure patients received consistent information and were supported to make informed decisions about their care and future wellbeing.

The service also considered accessibility across the wider organisation and had adapted services at selected locations to better support patients requiring additional adjustments.

The provider was open about the quality of care it delivered and published information about patient outcomes on its website, helping patients make informed choices about their care.

The evidence showed a good standard. Patients were usually supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Patients were supported to plan for important life changes and given time to make informed decisions about their future care.

Patients were supported to make informed choices about their care and treatment. Staff provided clear information about eye conditions, treatment options and the potential impact on daily life, allowing patients to make informed decisions. Patients told us the information they received was clear, accurate and easy to understand. Care and treatment plans were tailored to individual needs, and family members or carers were involved in discussions where appropriate and with the patient's consent.

Clinicians explained expected outcomes and, where necessary, reviewed treatment options over more than one appointment, allowing patients time to reflect on their choices. Staff also signposted patients to additional support services when required and ensured they understood how to access further advice if their circumstances changed.

Staff worked effectively as a multidisciplinary team throughout the patient journey. Optometrists, nurses and surgeons worked together to ensure patients received consistent information and were supported to make informed decisions about their care and future wellbeing.