Parkway

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question as good. At this inspection the rating has remained good.

We found the service was staffed and resourced appropriately, and significant efforts had been made to ensure that information was recorded and communicated consistently to referrers in a timely way.

However, not all staff working with children had the appropriate level of safeguarding training, and it was not clear that all equipment was scheduled to have regular servicing.

This service scored 66 (out of 100) for this area.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

This section was assessed using findings that are applicable to the whole Parkway site, which are included in the appropriate section of the surgery report.

The service’s referral and admission processes ensured that all essential information was received to determine if the service user’s needs could be safely met. The service also audited various aspects of the ENT pathway, including the time from referral to treatment, the time taken to refer on to secondary care, and the number of service users re-referred back to the service due to complications. These audits all showed good compliance.

The audiology service had recently implemented new technology to develop a digital clinical reporting form which makes service user data available immediately across the service, provided in a consistent format. This data can also be used to populate routine clinic letters, avoiding the need for dictation or transcription, and the service planned for this system to automatically send letters to GPs when it is fully embedded. The service reported that half of GP letters were now sent on the same day as the clinic as a result of this development, where their key performance indicator (KPI) required only a 5-day turnaround time.

The ENT service had also recently undertaken a quality improvement project that evaluated how making changes to the follow-up booking criteria would affect the service. These changes created efficiencies that allowed new service users to be seen more quickly by the service.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

We noted that safeguarding children level 3 training had not been considered as a requirement for staff whose clinical work included assessing and treating children and was instead only mandated for staff in leadership roles. As a result, some staff working with children did not have the correct level of safeguarding children training, which was not in keeping with the intercollegiate guidance document 'Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff’.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

Staff communicated with service users so that they understood their care and treatment, which included finding ways to speak to people who have different needs, such as by using telephone interpretation services.

Healthcare assistants also encouraged ENT service users at the conclusion of their appointment to fill out a feedback form, enabling the service to help ensure their needs had been met appropriately.

The ENT and audiology clinics inspected were accessible and met a good standard of hygiene, with appropriate hand-washing facilities. The outpatient waiting room at Parkway was a comfortable space that met the needs of service users.

We saw that in an audiology clinic all daily calibration checks on the equipment had been fully completed and that this was audited regularly to ensure compliance. Staff felt that leaders were very responsive if a problem was identified.

We were provided a device inventory that demonstrated that all listed equipment in the outpatient service was within its annual service date and had undergone portable appliance testing (PAT) appropriately. However, only the audiology equipment in use at Parkway could be found on the list, meaning that this was not a full inventory. Because of this, it was unclear if equipment in use at other sites was currently monitored or serviced. Based on the number of audiology clinics in operation, this was likely multiple pieces of equipment.

The service employed ENT and audiology clinical staff in a mixture of freelance, bank, and substantive posts, who could demonstrate the appropriate pre-employment checks and were able to meet the capacity of the service. Staff said they felt supported by leaders to manage their workload and capacity.

Staff confirmed with us that while there is no legal or regulatory requirement, audiologists working with children either possessed a full bachelor's degree in audiology or were directly supervised by a clinician who did so. All staff in ENT and audiology were registered with the appropriate regulatory body.

The number of staff in ENT and audiology who had evidence of an appraisal within the last 12 months was mixed. Freelance staff were required to provide evidence of an appraisal conducted during their work for another provider, and only one individual had done so. Compliance among ENT consultants was comparatively better, with 7 of 9 consultant staff having had a recent appraisal.

Staff understood and adhered to infection control principles and had access to suitable handwashing facilities. We saw that appropriate personal protective equipment (PPE) was available and used correctly by staff, and that the clinical environment met a good standard of cleanliness.

We observed staff dispose of single-use items and clinical waste appropriately, and that sharps bins were provided and being emptied regularly.

This section was assessed using findings that are applicable to the whole Parkway site, which are included in the appropriate sections of the surgery report.