Optimised Care Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led - this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this service. We rated this key question good, which meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff provided care within the provider’s purpose, principles, and values. Focused on improving access to treatment through reduced waiting lists, staff felt empowered by the culture and were confident in their contributions to success.

The provider’s vision focused on efficiency, expertise, and innovation. The team developed this to reflect plans for expansion with the future addition of other clinical specialties and new NHS contracts.

Staff we spoke with understand the provider’s values and vision and said they felt proud to work in a team that improved people’s lives through good standards of care. Staff who worked under practising privileges, service level agreements, or bank contracts, said they felt invested in the provider’s mission and understood their role in this.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and patients.

Staff at all levels have a well-developed understanding of equality, diversity and human rights, and they prioritised safe, high-quality, compassionate care.

The service had inclusive leaders who understood the context in which they delivered care, treatment, and support. They embodied the culture and values of the workforce and organisation. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They did so with integrity, openness, and honesty.

A director of clinical services, a ward manager, and an operations manager led day-to-day activity in the hospital. An administration manager, bookings lead, catering and housekeeping lead, and senior physiotherapist led their respective teams.

The ward manager was new in post. Staff said they felt supported and listened to. A nurse said, “No question is a silly question. [Ward manager] is really supportive.”

Staff said leaders were approachable and easy to contact for support or help. They noted the medical director met all staff on the days they were on site and introduced themselves to patients and temporary colleagues. Some staff said operational managers were not often present on the ward and they would like closer working relationships. We saw evidence that this would improve standards of practice on one day of our inspection when patient flow between the ward and radiology was delayed.

The provider maintained appropriate fit and proper persons checks and declarations for all senior managers and directors.

Every member of staff we spoke with felt able to contact any member of the leadership team and said they were confident they would be listened to and supported.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The clinical governance lead was the freedom to speak up guardian (FTSUG) and provided staff with the opportunity to discuss concerns or report unsafe practices confidentially.

Staff spoke positively about the culture and work environment and ability to speak up. We spoke with staff in a wide range of roles and at different levels of seniority and found consistently positive views of the freedom to speak up.

All staff we spoke with knew about the whistleblowing policy and how to use it. The team felt confident any concerns would be listened to and said they were empowered to raise issues or communicate risks.

Staff were empowered to speak up. The senior team had acted on concerns raised by staff to provide reassurance within a culture of confidentiality.

Staff said they felt respected, empowered, and supported by colleagues and managers. They said the provider’s efforts to create a positive place to work led to their long-term commitment.

The service treated bank staff with the same degree of support and training as permanent colleagues. Diversity policies applied to all staff groups regardless of contract, including student nurses and physiotherapists.

The provider made reasonable adjustments to the workplace to ensure staff with different access requirements could contribute meaningfully.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. The senior team acted on the information about risk, performance and outcomes, and shared this with others when appropriate.

The senior leadership team had acted on changing risks in the hospital caused by the legal status of the building operator to ensure they could continue to provide care safely. The service established its own medical gas supply, independent fire and environmental safety assessments, and implemented security to control access to the site. Staff maintained appropriate safety measures to protect their patients and colleagues, and the provider secured external support.

Business continuity plans reflected risks in the local environment and learning from past events, such as the risk of floods.

A director and the clinical governance lead were responsible for governance. They used a rolling programme of monthly meetings and governance forums to maintain oversight. Meeting minutes demonstrated consistent attendance by the right people and a decision-making process focused on safety.

Most care was provided for NHS patients from 7 different integrated care boards (ICBs) or NHS trusts. The governance team met with each ICB or trust at a frequency dictated by the contract. These included clinical and operational aspects of the service and enabled staff to discuss incidents, complaints, and challenges.

The provider carried out careful check of external partners providing care for their patients under subcontracting arrangements. This included a radiology service that provided radiographers and integrated reporting for X-rays.

The medical advisory committee (MAC) was responsible for oversight of surgical treatment and patient outcomes. A surgeon from each clinical specialty joined the MAC every quarter along with anaesthetists, the chairman, and the director of clinical services.

The provider understood their duty to collaborate and work in partnership. They shared information and learning with partners and collaborated for improvement.

The service had a good working relationship with NHS providers and ICBs, which enabled staff to jointly address challenges. For example, the services worked together to reduce waiting lists for surgical procedures in high demand.

Permanent staff described good working relationships with surgeons and anaesthetists who provided care under practising privilege arrangements. They said communication was consistent and they felt respected and listened. Staff understood the policy to follow if they had concerns about the practice or conduct of non-permanent colleague.

Staff had a good understanding of the challenges faced by patients in accessing care and their frustrations around waiting lists. Some patients travelled considerable distances for treatment and staff worked with them to make sure their experience met their needs.

As part of our inspection, we contacted an NHS trust who subcontracted the provider for their patients. Feedback after 200 surgeries was very positive and the trust noted the Optimised Care team were “very easy to work with.” They said the good relationship meant the organisations safely agreed on the most appropriate patients to undergo surgery in the hospital. The trust said, “The patients that have been treated by Optimised Care have had a really good experience and have been treated with great compassion and care by the admin staff, medical staff and ward staff, nothing has been too much trouble.”

The provider focused on continuous learning, innovation and improvement across the organisation and regional system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice.

The senior team coordinated short-notice surgery for a series of patients who had been victims of a provider operating that went out of business. They had paid substantial sums of money to a company not registered to provide clinical services and had no recourse to refund or treatment on the NHS. This provider worked with each patient to carry out their planned surgery, with a pre-operative assessment to make sure it was safe, at cost price. This meant patients still received treatment important to them.

Staff had encountered significant challenges and difficulties in the previous months due to the actions of another provider occupying the same building. In some instances, the actions of the other provider put staff and patients at risk. Staff demonstrated resilience and resolve and worked with senior leaders to make sure the service continued to provide safe care, adapting to the changing operating environment.

The service had ambitious plans for expansion, including the introduction of gynecology services, outpatient care, and expanded physiotherapy provision. Plans were based on the changing demands from NHS trusts, ICBs, and private patients. Staff understood where the most significant pressures were felt in the NHS and development plans reflected how the service could seek to address these in the future.

The director of clinical services (DCS) had significantly improved resuscitation training with practical scenarios and was in the process of completing ‘train the trainer’ accreditation. This would enable the provider to deliver basic life support training internally.