Urgent Care Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.
At our last assessment, we rated this key question as Good. At this assessment, the rating has changed to requires improvement.
 

This service scored 55 (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 treated people with kindness, and respected their privacy and dignity, where the environmental challenges allowed them to do so. Staff treated colleagues from other organisations with kindness and respect; however, we observed tense professional conversations between inter-departmental staff. Arrangements were in place to promote patients’ privacy. Friends and Family data reflected that some people felt listened to and were treated with kindness. From 1618 responses, 55.6% of respondents awarded 5 stars, 4 stars = 15.2%, 3 stars = 10.4%, 2 stars = 5.7% and 13.0% of patients awarded 1 star to the service.
Staff we spoke with understood Gillick competency and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.
There was a chaperone policy and signage advising people of their rights to a chaperone, although signs were inconsistently placed. We saw one incident on the provider log, where the chaperone policy was not followed, resulting in a complaint. There was evidence of delays in treatment which adversely impacted people’s comfort and dignity, including at the end of their life.
 

The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.
Patients’ personal, cultural, social, religious and equality characteristics needs were understood but not fully met. Patient communication needs were not always met to enable them to be fully involved in their care. There was little information available in other languages, for people with a learning disability or dementia, or for people with a hearing or visual impairment. The overcrowded environment could be difficult to tolerate for patients with dementia, sensory needs, disabilities, or poor mental health, and older patients, for example. Digital check-ins were only available in the English language and did not take account of diversity or the digitally excluded population.
 

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.
Staff helped patients and their carers to access advocacy and community-based services. The provider was actively working with the local authority and other partners to develop a single point of access / care coordination hub to keep people out of hospital where appropriate. They were also involved in a partnership project called the Thrive Project to encourage patients to develop skills of self-care in their own communities. These initiatives were in their infancy, but collaboration had begun positively.
 

The service listened to and understood patient’s needs, views and wishes but was not always able to respond to these within a system under pressure. Staff tried to respond to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Staff told us that they did not feel their needs were heard by the provider, when they raised concerns. CQC inspectors observed a patient in pain and distress on the floor, in the corridor, as the waiting area was full.
There was a system for appointment triage that ensured people with immediate needs had access to services, but this relied on the patient giving all the correct information at digital check-in and being referred to the correct department appropriately. There was a health care assistant on duty to assess baseline observations within 30 minutes of arrival at the UTC. However, during busy periods it was difficult for this to be achieved. The pressures on the system were unpredictable, and this increased pressure on staff and decreased the tolerance of patients’ ability to cope with the wait times. If patients failed to wait and complete a consultation, there was a system to perform a welfare check on them after they left. However, there were many patients in this clinical triage queue. We saw there was a 4-day backlog of follow up calls that had not yet been made.
Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams.
 

Some staff told us they were valued by leaders, but others did not feel this way. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included VIP Suite (an exclusive rewards portal for FCMS employees) where they could access online counselling and staff support or coaching. At location level, the necessary resources and facilities for safe working, such as regular breaks and rest areas were not available. Staff were working in a hot, cramped environment with no staff communal area. The service manager was approachable and had an open-door policy for interacting with staff. We observed this interaction several times during our assessment. Staff feedback told us that there was management support in place, but this was non-clinical and resulted in a disconnect when clinical concerns were raised by staff. There was a lone working policy and cars used for home visits were tracked to provide additional safety to clinical staff.