Nurse Richard – The Wax Wizard

On this page

• 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

This means we looked for evidence that the service met people’s needs.

This is the first assessment of this service. This key question has been rated as good. This meant people’s needs were met through good organisation and delivery.

Staff delivered person-centred care and involved patients and their parents in decisions about their care and treatment. Patients and their parents were made aware of how to raise concerns, give feedback or make a complaint.

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 make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

The provider explained the treatment as part of the assessment and consent process. The use of an endoscope (tiny camera) inside the ear enabled patients and their parents to see what was happening on the screen in front of them throughout the procedure. The provider tailored this to the age and needs of the child.

The provider used microsuction with most patients, but gave them and their parents the option of other treatments if this was relevant. The provider discussed with patients and their parents how they dealt with ear wax and advised on how they could do this safely. Patients may also attend to have objects removed from the ear canal. If there were problems that needed immediate or further attention, the provider advised the patient to attend their GP or occasionally the emergency department. The provider would write a supporting letter, with information about the findings. The provider could supply photographs and videos of the inner ear/treatment to the patient if they wished.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

The provider planned and organised services, so they met the changing needs of the local population. The service was open to anyone, regardless of where they lived. However, the provider told us that they had originally opened the service because of a shortage of timely provision in the local area.

Facilities and premises were appropriate for the service being delivered. The service is on a small high street and is accessible by bus and car. The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. The service was on the ground floor and could be accessed by people in a wheelchair.

The provider monitored and took action to minimise missed appointments. The provider told us that there were rarely missed appointments, as patients were usually keen to have the blockage in their ear removed. When this did happen, the provider contacted the person, and there was usually an unavoidable reason for them missing their appointment.

The provider made sure patients and their parents could get help from interpreters or signers when needed. The provider told us that if a patient did not speak English fluently, they usually brought someone with them to interpret or used online translation tools.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

The provider had an established website that contained information about their services, and ear wax removal generally. This included videos of what happened in the service, and a walk through of the building and treatment room. The provider had an online channel of videos of ear wax or object removal, and used these to promote positive ear health.

Information was displayed about how to give feedback or make a complaint about the service, including to CQC.

When patients or their parents booked an appointment, they received a confirmation text which advised them how to get there, and informed them that that they could wait in the reception area.

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.

If patients were provided with ear sprays they were given an explanatory leaflet. This clearly described when and how the sprays should be used, how they should be stored, and when medical advice should be sort. The information described any limitations of their use with children, and under what age they should not be used unless directed by and in consultation with a doctor.

If patients needed further treatment, the provider directed them and their parents to their GP or the local emergency department. The provider supplied a paper/electronic letter explaining what they had found, relevant advice on further investigation or treatment, and included photographs or videos where necessary.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

The provider had a process for managing and reviewing complaints. The policy included information about how to make a complaint, timescales for a response, and how to escalate concerns if the complainant was not satisfied with the outcome. The provider was a sole trader, and had an arrangement with an external practitioner to review complaints if necessary.

There had been no complaints about the service.

The provider told us that as part of providing care to patients, they asked if they had any concerns and would try and address these if they arose. Information was on display about how to leave feedback about the service, both to the provider and to CQC.

We make sure that everyone can access the care, support and treatment they need when they need it.

Managers monitored waiting times and made sure patients could access services when needed. Appointments were usually available within a few days, and patients could see available slots when they booked online. The provider was a sole trader, so if they were unwell they may have to cancel appointments. However, this rarely happened, and if it did the provider would rearrange appointments as soon as possible. The provider told us that if a patient needed urgent treatment, they may recommend alternatives.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

The provider promoted a culture in which patients felt empowered to give their views. Staff had completed training trained in equality, diversity, and human rights.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

This quality statement is not applicable to this service. The service may provide care to people who are receiving palliative care, but this would be part of their general care provision, not an end-of-life pathway.