Practice Plus Group Hospital - Barlborough

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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 had their needs assessed and were treated in line with evidence. We looked for evidence that staff worked well together and monitored patient outcomes. We looked for evidence that patients were supported to live healthier lives and consented appropriately.

At our last inspection we rated this key question as good. At this inspection the rating has remained good. This meant that patients were treated in line with evidence and had their needs assessed. Staff monitored patient outcomes and worked well together. Patients were consented appropriately and supported to live healthier lives.

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.

We scored the service as 3. 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.

Staff in the outpatients department had a morning huddle where they discussed the upcoming patient activity.

Patients were placed on appropriate pathways for their procedures, ensuring their pain and other perioperative needs were assessed and managed in line with their planned care. We reviewed three outpatients care records and these were fully completed with all the relevant information. Staff reviewed patients physical, health, wellbeing and communication needs. Staff keep clear, detailed, person-centred records to support patients needs.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered patients’ 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.

Please refer to the surgery section in the report for this location for the main details about this quality statement.

The outpatients team included or had access to the full range of specialists required to meet the needs of patients in the service. Outpatients teams used assessments pre surgery that were based on best practice.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support patients. They made sure patients only needed to tell their story once by sharing their assessment of needs when patients moved between different services.

Please refer to the surgery section in the report for this location for the main details about this quality statement.

Staff in the departments worked collaboratively across professional groups to support good outcomes for patients. Doctors, anesthetists, physiotherapists, nurses and reception staff communicated well and demonstrated mutual respect throughout the inspection. Staff described positive working relationships between medical and nursing teams, and several staff we spoke with commented positively on the strong teamwork on site and how this contributed to safe and effective care.

Staff felt there was effective communication, coordination and collaboration with external partners.

We scored the service as 3. 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 patients to live healthier lives and where possible, reduced their future needs for care and support.

Please refer to the surgery section in the report for this location for the main details about this quality statement.

Patients received clear practical information preparing them for surgery, recovery, and informed decisions supporting outcomes. Patients were provided with both verbal and written surgery specific information throughout their pre-operative outpatients appointments. Nurses discussed specific risk factors with patients such as drinking alcohol and smoking.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored patients’ 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.

Please refer to the surgery section in the report for this location for the main details about this quality statement.

We scored the service as 3. The evidence showed a good standard. 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. Patients were made aware of the risks and benefits of the surgery beforehand, and this was documented in patient records. We saw staff discuss different anaesthetic options patients had for their procedures, including the risks and benefits.

Consent was gained in line with legislation and national best practice. We saw that during all tests and procedures that were undertaken by staff they always explained what they were doing and gained consent from the patients. Consent was always recorded in patient records.

They followed national guidance on consent and understood their responsibilities under the Mental Capacity Act 2005 (MCA). Staff knew how to support people who lacked capacity to make their own decisions. The service had an updated consent policy that reflected national best practice and the requirements of the Mental Capacity Act 2005.

Staff understood how and when to assess whether a patient had capacity to make decisions about their care. They told us concerns relating to mental capacity were usually identified during the preoperative assessment, and the consultant performing the procedure completed the assessment when needed. Staff followed the service’s policies on consent and mental capacity. Staff compliance with consent training was high, at 98%.