CHEC - Kings Norton

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

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

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.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Person centred care was achieved through consultation, pre assessment calls and on the day of the procedure. Daily huddles ensured that all staff were aware of the needs and risks of individual patients. This included the need for translation services or assistance getting on and off the bed. Consultants discussed the proposed treatment with patients and took account of their wishes. For private ophthalmology patients there were two choices of lenses. These were explained to the patient to ensure they understood the differences and chose the one they wanted based on a good understanding of what the lens could achieve.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. NHS patients came from within the wider community of Birmingham. The staff also lived in this community and therefore understood the challenges that these communities faced. Information was shared with the healthcare provider and the patients GP as appropriate. Patients were sent home with a discharge letter describing their surgery in case of any urgent concerns which took them into another provider to ensure they were well informed. The service also had an urgent telephone help line available to patients to support with any post-surgery complications and advice. This was available 24 hours a day, every day and was answered by a clinician.

The service supplied accurate and up-to-date information in formats that were tailored to individual needs. Leaflets provided complied with the Accessible Information Standard. Staff signposted patients to local services and treatments as necessary. There were posters on the walls informing patients how to complain should they wished to, and staff were approachable. We saw that paper records were stored in locked cupboards and electronic devices were “locked” when not in use. Patients were supported by staff to complete any forms that were required. Forms were mainly held on a tablet so could be enlarged for patients with limited vision. The endoscopy staff had access to a room they could use if a consultant required a confidential and private discussion with patients, such as when an obvious cancerous tumour had been found or any issues spotted during a colonoscopy.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. The service had received 2 complaints in the previous 12 months. Complaints were dealt with promptly and discussed at all levels of the organisation to ensure that if any learning could be devised from a complaint this was shared across all sites. This promoted a no blame culture.

Senior managers told us complaints were generally about administrative errors occurring. The data demonstrated that these were related to communication issues about appointments. Staff were reminded about the need to be vigilant of administration errors at daily huddles and team meetings. Patients who raised concerns were given feedback as to what had been done to ensure improvements in practice. An example of this was when a date of birth had been recorded incorrectly the patient had been contacted and their date of birth checked with them. Quality bulletins were produced monthly and these contained information on the trends and themes from complaints and any learning identified.

The service made sure that people could access the care, support and treatment they needed when they needed it. As discussed above, the service and staff made sure that they made reasonable adjustments for patients. Whilst there were medical staff available on the day of procedure there was an on-call service which ensured that anyone could contact a medic should they have any concerns. This service was available 24 hours a day, every day. If an appointment was necessary following medical advice an on-call clinic manager was able to book patients into be seen. Staff ensured that discharge arrangements were applicable to the patient. This included the provision of Home to Hospital transport for those who required this post procedure due to medications used in the procedure.

The service was accessible for patients with limited mobility. Wide corridors and step free access to the service which was all on one floor meant that patients who used either walking aids or wheelchairs were able to access the service. The service was able to adapt to most patients’ individual needs. However, they made sure at preassessment that the patient was able to transfer on to the operating bed within limited assistance prior to operation. The electronic patient record captured and flagged where an interpreter was required, if transport was required, if the patient was a wheelchair user or had mobility issues, were deaf or required a hearing loop, if the patient had learning disabilities or were vulnerable in any way. Staff had completed training on autism and dementia to ensure that staff knew how to respond to patients to break down communication barriers and reduce behavioural triggers.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For example, patient feedback highlighted a greater need for translation services. The provider ensured that a translation application on a tablet was available to support patients whose first language was not English. The manager had knowledge of which members of staff spoke which language and they could be used to ensure the patient understood and were reassured. Further developments were underway to improve leaflet production in a wide range of languages. Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Staff were trained in equality, diversity, inclusion and human rights. They used this training to ensure that the service met the needs of the patient. Patient demographic and outcome data are regularly reviewed to identify any disparities between patient groups. This includes analysis of waiting times, cancellations, and satisfaction levels among patients with disabilities or language barriers.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future. Patients’ care and treatment was explained to them. Patients paying privately could choose between a variety of lenses and this was explained to them as were the benefits of each. Those patients on NHS pathways were given an explanation of the treatment, the proposed benefits and how the benefits would be realised over time. Patients were also given information on how to contact support if required.