Spire Harrogate Clinic

On this page

• 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

People who used the service were involved in assessments of their needs. Staff carried out assessments taking account of people's communication, personal and health needs. Care was based on latest evidence and good practice, policies were updated and referenced to national guidance. Patient reviews took place with other healthcare professionals to ensure patients were given a holistic approach. Staff made sure people understood their care and treatment to enable them to give informed consent. 

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 evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. 

The service had a comprehensive assessment policy for staff to follow. It clearly outlined the roles and responsibilities of staff and that all relevant assessments must be undertaken by registered staff who have successfully completed relevant supervised practice. 

The service had a clear pathway that assessed whether people who accessed the service met the clinical risk criteria to be treated at the clinic or they were referred to a more appropriate service. Those deemed too high risk would be referred to the NHS. The service had good relationships with other local services, therefore they ensured that any outward referral was discussed and approved to ensure a smooth transition without delay. 

The service ensured that patients’ needs were met, there was an interpreting service available, and this was well publicised through the staff notice boards. Booking staff told us that they highlighted to the clinic staff where additional support was required. 

Staff used hospital passports to help them make reasonable adjustments for people with communication needs, autism and/or learning disabilities. 

Staff completed care pathways and risk assessments with patients. Our review of records showed these were complete.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They 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. 

The clinic’s overarching policies were produced and reviewed centrally by the Spire corporate group. However, the clinic had been given autonomy to adapt corporate policies to better align with their clinic where they felt appropriate. Staff were able to access all policies on the clinic computer system. We sampled the policies and found them in date and evidenced based with references to key national documents. 

The service worked closely with the group and with local and national services in order to ensure that they were up to date with processes and took every opportunity to develop the clinic to benefit their community. 

The clinic had a comprehensive audit programme, which was carried out by a variety of staff to give them the opportunity to take responsibility for their areas and make improvements where required. Staff said they enjoyed this part of their role and being more aware of processes, outcomes and how they, personally contributed to service management and improvement. 

The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. 

The service worked collaboratively as a multidisciplinary team, the clinical service manager and heads of departments had regular meetings to share information. This was cascaded to teams which we observed whilst on site. Staff had monthly team meetings where information was shared. There was also sharing at corporate level with staff having the ability to join national conferences with the wider Spire group. 

Staff told us how well the team worked together to manage patient risk, the wider clinical team met to discuss any higher risk patients to decide whether they could safely be treated at the hospital. 

We heard at the morning huddle staff being praised within the teams when they had provided extra support to both staff and patients. 

We saw how well staff worked together for the benefit of the patients. Patients were warmly welcomed at reception and walked through to introduce them to the outpatients department staff who then greeted them and confirmed their appointment before the reception staff left. The consultant came to collect the patient when it was time for their appointment and asked if they would like anyone else to accompany them. Staff were ready and available to support the patient in any way.  

We spoke with patients in the department who said they ‘could not fault their care from start to finish’. When they had been referred on for further treatment, their consultant from the clinic was involved throughout and saw the patient for follow up appointments while continuously liaising with other clinicians involved in their care and treatment. The consultant personally rang the consultant referred to in order to ensure there were no issues accepting the referral and so that they were fully informed ahead of the patient’s next appointment.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support. 

The service supported patients to manage their health and wellbeing. 

The department had noticeboards, which included health education promotion including smoking cessation and mental health. Staff promoted health and well-being through the patient information booklet. 

We saw signs showing 10 great stress busters, such as exercise, smile, enough sleep and rest, eat a healthy diet and manage time well.  

There were ‘mental health matters’ signs providing signposting for support if needed, including the clinic mental health first aiders. It shared tips to look after your mental health and what are the signs that you may need some support.  

In addition to these, there were posters with QR codes for anyone to find information on improving wellbeing. These included getting active, losing weight and understanding high blood pressure. 

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 service monitored any adverse outcomes through their incident reporting system and had implemented actions where required.  

The service monitored and improved outcomes for patients through strong local partnerships. The service had strong relationships across the local healthcare system, they attended numerous meetings to share information, outcomes and improvements for shared learning.  

They also met regularly with corporate leads and used incidents and never events from other providers as a basis for some of their own training as well as staff meetings to discuss these and learn from them to put things in place in their own service to prevent them.  

They had a robust and comprehensive clinical and non-clinical audit programme. We reviewed outcomes and saw that all local audit results achieved 100% with the exception of hand hygiene at 98% for that quarter. No actions were required at that time as all local audits had met their target.  

The clinic had a consent policy, this was also displayed on information boards and was audited. The service currently had paper records. During this assessment we reviewed patient records and saw consent clearly documented. We observed patients being given informed consent in clinic giving the risks and benefits to the procedure. Patients told us they understood their treatment, however staff knew what to do if they were concerned about a patient’s capacity to consent. 

The service carried out consent audits, however these were clinic wide and not outpatient specific. It showed 94% compliance across the clinic and as this did not meet target, there were actions implemented immediately.