CES Medical - Headcorn

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that patients and communities had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patients were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This is the first assessment since registering to provide a regulated activity. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The service made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed care records on site and found the service assessed and recorded patients’ health, wellbeing, and communication needs consistently. Records showed staff completed appropriate clinical assessments, considered individual risks, and documented consent. The service clearly recorded patients’ communication needs and provided information in a way patients could understand. Care records demonstrated that staff involved patients in decisions about their care, explained treatment options and aftercare clearly, and reviewed needs at key stages of the pathway to ensure care and treatment remained effective.

The service planned and delivered patients’ care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. At the time of the assessment, the provider's leaders were undertaking training to support the implementation of the Patient Safety Incident Response Framework (PSIRF). PSIRF is an NHS framework designed to help organisations learn from patient safety incidents and improve the safety of care. We were told about the commitment to follow this framework when they could effectively embed it. All policies we looked at contained a creation and review date, and clear references to current national guidelines. There were systems to communicate changes in guidance through meetings and management newsletters. We saw notice boards displaying up to date guidance to staff.

Polices and processes took account of changes to the Royal Colleges guidelines and National Institute for Health and Care Excellence guidelines.

We reviewed 5 care records for evidence of completion of care plans and risks assessment of patients and found all were completed correctly.

The provider delivered minor operations as a same‑day discharge service with no routine follow‑up. Patients were given a telephone number to contact at any time if they had concerns or experienced problems after the operation. The service managed patient safety through careful pre‑procedure assessment, strict infection control, and clear aftercare instructions. The team reviewed any concerns reported by patients or the NHS through formal clinical governance processes.

The service worked well across teams and services to support patients. Doctors, nurses, and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

Staff reported healthy working relations across staff groups including between medical and nursing teams. We saw and heard examples of effective team working which was based on mutual respect and trust.

Teams and services shared information to ensure continuity of care. Following each episode of care clinicians sent a discharge summary or clinic letter to the referring clinician. Patients left the clinic with information about the treatment they had received and how to contact the service if they had concerns. The provider had an on-call rota of clinicians who responded to patient concerns within 30 minutes of receiving a call. This service was available when the clinic was closed to ensure patients had access to timely clinical advice and support.

The service supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

The provider supported patients to live healthier lives by promoting eye health, preventing avoidable sight loss and supporting independence. This included early detection and management of eye conditions, patient education and improved access to care closer to home, helping to reduce health inequalities and support overall wellbeing.

Patients undergoing elective operations had access to information about their condition, their treatment and how best to prepare for surgery. Staff spoke with them about how best to optimise their outcomes after surgery and how to modify their choices to ensure better health.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider demonstrated effective monitoring of clinical outcomes through regular audit and benchmarking. Outcomes compared favourably with national standards, including a posterior capsular rupture rate of 0.2% and postoperative visual outcomes that exceeded national benchmarks. The service also monitored postoperative complications and reported no chronic complications during the reporting period. Leaders used this information to provide oversight of performance and support continuous improvement.

The service had been accredited under relevant clinical accreditation schemes. The provider held appropriate professional registrations and accreditations to deliver a community ophthalmology service safely and effectively. Clinical staff were appropriately registered with their professional regulators, including the General Medical Council, Nursing and Midwifery Council and Health and Care Professions Council. Care delivery was aligned with guidance from the Royal College of Ophthalmologists, and the service participated in relevant clinical audits to support quality assurance. Together, these arrangements provided assurance that care was delivered in line with national standards and professional requirements.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. During the assessment we observed patient appointments and saw staff obtained verbal consent from the patient before the examination.

Staff followed the service’s policies related to consent. Staff gained consent from patients for their care and treatment in line with legislation and guidance. The most appropriate doctor sought consent for surgery and included discussion about the benefits, potential complications, the risks and alternative options. Patients signed their consent forms at the consultation before the procedure. Staff then rechecked consent on the day of the procedure. The service completed consent audits and shared outcomes with staff.

Interpreters were available to support patients to give informed consent, including for British Sign Language and face to face interpreting when necessary. Staff received training in the Mental Capacity Act (2005), understood their responsibilities under the legislation, and applied it in practice to support patients to make informed decisions about their care and treatment. Staff communicated information in a way patients could understand, checked their understanding throughout the consent process, and took appropriate steps to assess capacity where there were concerns. This helped ensure patients were involved in decisions about their treatment and that consent was obtained in line with legal requirements and best practice.