Nurse Richard – The Wax Wizard

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment of this service. This key question has been rated as good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

The service treated people with kindness, empathy and compassion and respected their privacy and dignity.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

Staff were kind, professional and responsive when caring for patients. Staff took time to interact with patients and those close to them in a respectful and considerate way. We had limited direct feedback from patients, but general feedback was that they were treated well and with kindness.

Staff followed policies to keep patient care and treatment confidential. Records identified patients’ needs, the treatment they had received, and future plans. Staff understood and respected the individual needs of each patient.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients, for example by ensuring disabled people had access to the premises. The service had initially been on an upper floor which could only be accessed by stairs. However, it had now moved to the ground floor where it could be accessed by people with limited mobility, or those in a wheelchair. Wheelchair users could choose to remain in their chair throughout the procedure.

The provider told us that children, particularly younger children, may find it more difficult to sit still throughout the procedure. With this there is an increased risk of jabbing the patient’s ear drum because of a sudden movement. The provider told us that using an endoscope reduces this risk as it gives a better view inside the ear and is more controlled. Children may be attending because they have inserted objects into their ears that need removing. However, if there is wax build-up, the provider said that it was important to know when to stop the procedure, as it wasn’t always necessary to remove every speck of wax if that may increase the risk of damage.

The information provided was in a form accessible to patients or their parents. People could contact the service and book appointments by phone, text or online.

In the treatment room there was a drawing of the anatomy of the ear. The provider could use this to help explain the procedure or the patient’s presenting condition.

The provider ensured that patients had access to interpreters or signers when needed. The provider told us that if a patient or their parents did not speak English fluently, they usually brought someone with them to interpret. If this was not possible, they could access online translation tools.

Children receiving treatment were always accompanied by their parent or guardian.

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment, and wellbeing.

The provider explained to patients and their parents the benefits and risks of microsuction over irrigation for ear wax removal, so that they could make an informed decision.

Patients and their parents could watch what was happening inside their ear throughout their treatment. They could see what the problem was (usually wax or an object) and they could see when this had been removed. The provider told us that most people watched their treatment, but they could choose not to if they wished.

Patients or their parents chose to come to the service. The production of ear wax is normal and healthy, but for some people the build-up can cause problems, and there may be limited actions a person can take to prevent this. The provider monitored new and return visits, and saw an increase in the number of people using the service and the number of returning patients.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

The provider was aware of and dealt with any specific risk issues and planned for these accordingly. This may include continuing with the procedure, or if there were further concerns they may stop or not carry out the procedure, and refer the person to their GP (for assessment, treatment or an ENT (Ear, Nose and Throat) referral) or to the emergency department. The provider gave examples of when this had happened.

The provider was a sole trader, registered nurse and non-medical prescriber, although they did not administer medicines at the service. Patients were asked about their health and medical history as part of the assessment and consent process. The provider was confident in their ability to detect concerns and take appropriate action.

The provider mainly treated adults but also saw a small number of children each week. The provider was aware of specific challenges when working with children – the ear is smaller, the child may be more likely to move around, or to become upset. The provider adapted to the child in how they explained the procedure, and whether the child wished to see this on screen.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

The provider was a sole trader, and the only person working in the service.