Atrium Health Centre

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

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. We also looked for evidence that staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement.

This service scored 54 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Reception staff used digital flags within the care records system to highlight specific individual needs, such as the requirement for longer appointments or a translator. Staff checked people's health, care and wellbeing needs during health reviews. People with a learning disability were identified on the clinical system and invited to attend annual health reviews.

The service used ‘Dorset Care Plans’, which are personalised care plans that outline a person's health and social care needs, agreed goals, planned interventions and the professionals responsible for each aspect of their care. These plans were designed to support coordinated, person-centred care and help ensure people received joined-up support across multiple services and organisations. These arrangements helped staff assess and review people’s needs in a person-centred way.

The service did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Systems were not in place to ensure staff were up to date with evidenced based guidance. Clinical records we reviewed did not demonstrate care was being provided in line with current guidance.

During our remote clinical searches, the monitoring of people with long-term conditions was not always in line with National Institute for Health and Care Excellence (NICE) guidance. For example, 24 people diagnosed with asthma had been prescribed 2 or more courses of rescue steroids within the previous 12 months. We reviewed 6 of these records and identified 3 people had not received an adequate asthma review within the last 12 months as recommended. Records reviewed also demonstrated variation in prescribing practices and follow-up arrangements for people prescribed repeated courses of rescue steroids. One person identified as being at higher risk had not been issued with a steroid card in line with national guidance. Records showed this person had received multiple courses of steroids over time and had not been prescribed a preventative inhaler. This increased the risk that their asthma was not being managed in line with best practice and that deterioration in their condition may not be identified or addressed in a timely way.

We identified 10 people with hypothyroidism who were overdue thyroid function test (TFT) monitoring, as recommended by national guidance. TFT monitoring is used to assess thyroid hormone levels and support the safe management of thyroid conditions. We reviewed 5 of these records and found 3 people remained overdue their required monitoring at the time of our assessment. Records also showed that the required monitoring checks had not been completed prior to issuing their most recent prescriptions. Therefore, although the service had identified these people and had processes in place to recall them, the required monitoring remained outstanding.

We identified 65 people with diabetes whose HbA1c levels, a measure of average blood glucose levels over the previous 2 to 3 months, were above the recommended target range. We reviewed 5 of these records and found that, for 2 people, blood pressure monitoring had not been completed at the time of our assessment. Records showed that blood pressure reviews had been arranged; however, the required monitoring remained outstanding. In one case this was because the person had not attended their booked appointment, despite further attempts by the service to engage with them.

We shared the results of our searches with the provider, who promptly followed up people where monitoring remained outstanding.

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.

Staff had access to the information they needed to assess, plan and deliver people’s care, treatment and support. The service worked collaboratively with other providers to ensure continuity of care, including where clinical tasks were delegated.

The service worked with external teams, including frailty, district nursing, hospice and community services, to coordinate care for people with more complex needs. MDT meeting minutes and shared records demonstrated multidisciplinary discussions that supported information sharing, reduced duplication and helped staff provide joined-up care when people received support from more than one service.

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, reduce their future needs for care and support.

The service supported people to live healthier lives, including those in the last months of life, people at risk of developing long-term conditions, and people with caring responsibilities. Staff promoted national priorities and initiatives aimed at improving population health, including smoking cessation and obesity reduction.

The service’s clinical system included digital flags to identify people with specific needs, including carers. These individuals were signposted to the social prescribing team, which provided access to community support groups and wellbeing services.

End-of-life care was provided in partnership with external organisations, including hospice services, to support people approaching the end of their lives. Meetings were held when required to review care needs and coordinate support.

The service was accredited as a military veteran-friendly service. Veterans were appropriately coded within the clinical system, enabling reasonable adjustments to be made, including access to extended appointments and annual health checks.

A health monitoring machine was available in the waiting area, enabling people to undertake self-screening when attending the service.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service's uptake of cervical screening was below national targets for eligible people. NHS England verified data for 2024 showed that 72.5% of eligible people aged 25 to 49 years had received cervical screening, compared with the national target of 80%. For those aged 50 to 64 years, uptake was 75.6%, which was also below the national target of 80%. The service told us that more recent data showed uptake had improved to 85.6% for those aged 25 to 49 years and 87.1% for those aged 50 to 64 years, however this was locally produced data and was unverified.

Uptake rates for 3 of the 5 childhood immunisations were also below national targets. Data for the period 1 April 2024 to 31 March 2025 showed that only 88.1% of children aged 2 years had received their first measles, mumps and rubella (MMR) vaccination, compared with the World Health Organisation (WHO) target of 95%. During the same period, only 88.1% of children aged 2 years had received their Hib/MenC booster vaccination and 83.3% had received their pneumococcal booster vaccination. These rates were also below the WHO target of 95%.

We raised these results with the service who could not demonstrate effective systems to routinely monitor outcomes or use performance data to drive improvement. Although cervical screening and some childhood immunisation uptake rates were below national targets, there was limited evidence that targeted actions had been implemented, monitored or reviewed to improve uptake.

The service was able to provide evidence of 1 clinical audit completed in March 2026, which focused on people with anaphylaxis, and the audit findings identified some areas for improvement. The audit had reviewed 23 records of people prescribed adrenaline auto-injectors and found that all people had been prescribed 2 auto-injectors as per recommended guidance, had been advised to carry both at all times, had been shown how to use them and given appropriate advice about their use, storage and replacement. However, the batch number and expiry date were recorded in only 1 of the 23 records, and 4 people had not been advised to download the supporting anaphylaxis app. The service was unable to demonstrate how these shortfalls had been addressed as a result of the audit, nor any other programme of clinical audit activity to routinely monitor the quality of care and treatment provided.

The service did not tell people about their rights around consent, or respect these when delivering care and treatment.

Information relating to people's care and treatment decisions was not always accurately recorded. During our onsite visit, we reviewed 5 records for people who had been assigned a clinical code indicating a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision was in place. It was identified that within 3 of the records, consent for a DNACPR had not been obtained, despite the coding being applied. There was no supporting documentation within the clinical record to demonstrate that the decision had been discussed with the person, agreed, or formally recorded. The service had not identified this issue prior to our inspection. During their own review after we shared our findings, the service identified that the wording within a paramedic request template may have contributed to an incorrect option selection, resulting in some people being coded as having a DNACPR decision inappropriately. This created a risk that consent to care and treatment decisions relating to resuscitation was not appropriately obtained, recorded, or evidenced within people's clinical records.

The service was informed of these concerns during our onsite visit and was instructed to take immediate action to review affected records and address any risks arising from the incorrect coding. A short timeframe was provided for the service to submit evidence demonstrating that all affected records had been reviewed and corrected where required. Service leaders advised they would be away from the service the following week and requested additional time to complete the review. Whilst they advised they would inform the local primary care network and paramedic home visiting team of the concern, evidence was not provided within the requested timeframe to demonstrate that the necessary review had been completed and that people were not at continued risk. The service did provide a significant event analysis relating to the concern; however, this had not been completed and was scheduled for discussion on 9 June 2026. The information submitted also did not include evidence to demonstrate that the requirements of the Duty of Candour had been considered or applied in relation to the identified concerns. Therefore, at the time evidence was requested, the service had not provided assurance that all affected records had been reviewed, corrected where required, and that people were not at continued risk.