Atrium Health Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

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

This service scored 61 (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 were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff told us interpreter services were available where required for people whose communication needs could not be met through usual methods. These needs were coded within the clinical system to enable services to be arranged in advance where necessary.

The service had made reasonable adjustments for people who experienced difficulties accessing services. This included home visits by GPs or primary care network (PCN) paramedics where appropriate. The service also held regular multidisciplinary team (MDT) meetings with other healthcare professionals, including frailty and palliative care teams, to coordinate care and help ensure people received person-centred support that reflected their individual needs and circumstances.

However, during our onsite visit, the hearing loop available in the reception area was found not to be switched on. When asked, staff told us they were unsure how to operate the equipment and that it was not routinely used, as people attending the service had been able to communicate through lip-reading. This meant the service had not considered the needs of people with hearing impairments who may be forced to ask for adjustments rather than it be readily available.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service worked with a multidisciplinary frailty team, made-up of different healthcare professionals, to develop and review care plans for people with complex needs. The service also worked closely with local hospice and district nursing teams to support people receiving palliative care. Shared clinical records enabled healthcare professionals involved in people's care to work together, coordinate care and support continuity of care.

However, appointments were not always available with a preferred GP, which limited continuity of care for some people. Data from the National GP Patient Survey and feedback reviewed during the assessment indicated that people did not always have access to their preferred healthcare professional. The service had been recruiting additional GPs to improve continuity of care and, during our assessment, told us additional GPs had been recruited and were due to start over the coming months.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

During our onsite visit, we observed health promotion information relating to national screening and immunisation programmes displayed in waiting areas. This information was also available on the service's website. The service supported people to access information in a way that met their communication needs. Interpreter services, including Language Line and British Sign Language (BSL) interpreters, were available to support people whose first language was not English or who had communication barriers. The service could also provide leaflets in other languages and easy-read formats on request. Information relating to reasonable adjustments was clearly outlined on the service's website. These arrangements helped ensure people could engage in meaningful discussions about their care and access relevant health information when required.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had a complaints process, supported by a designated complaints lead and a complaints policy. Information on how to make a complaint was available on the service's website. We reviewed a sample of complaints and found they had been managed appropriately, with an apology provided where necessary and information about escalation to the Parliamentary and Health Service Ombudsman provided when required. Staff were able to describe learning from complaints and changes made in response to feedback. For example, following a complaint about a text message asking a person to book an appointment after receiving test results, the service identified that an outdated preset message had been used. As a result, the message template was amended to remove incorrect timescales and provide clearer instructions for people. Complaints and associated learning were discussed at meetings and formed a standing agenda item to support continuous improvement.

The service website also provided clear information for people about opening times, registration, available services, repeat prescriptions and the complaints process. Leaders told us they regularly gathered feedback through the NHS Friends and Family Test and used this to identify areas for improvement. However, although actions identified from Friends and Family Test feedback were documented, records did not always include timescales for completion or evidence that actions had been completed.

The service made sure that people could access the care, support and treatment they needed when they needed it.
People could access the service in a range of ways, including online, by telephone and in person. Consultation rooms were available on both the ground and first floors, and a lift was available for people who required it. The service had made reasonable adjustments for people who found it difficult to access services, including home visits provided by GPs or primary care network (PCN) paramedics where appropriate. Approximately 120 people were identified as housebound and received support through these arrangements.

During our onsite visit, urgent same-day appointments were available. Whilst more routine appointments, including cervical screening, flu clinics, NHS health checks, phlebotomy and long-term condition reviews, were available within the next 2 weeks. Staff and external professionals also had access to a bypass telephone number to support urgent access where required.

However, feedback received through the service's Friends and Family Test and CQC’s Give Feedback on Care submissions highlighted some concerns relating to appointment communication, cancelled appointments, late-running clinics and people's understanding of the purpose or appropriateness of appointments. The service told us they monitored feedback and identified areas for improvement to help address these concerns.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service had processes in place to support people to register, including those in vulnerable circumstances, such as people experiencing homelessness and Travellers.

The service had achieved the ‘Pride in Practice Gold Award’, recognising its work to support LGBTQ+ people. During our onsite visit, we observed information displayed in the waiting area signposting people to a range of support services, groups and helplines, including those available to people from minority ethnic communities.

The service promoted the development of an LGBTQ+ patient participation group (PPG). QR codes were displayed throughout the service, providing access to information about LGBTQ+ events, services and news. However, on reviewing the service’s website information relating to LGBTQ+ support and patient participation group activity had been logged on the service’s website since 2024 without evidence of review or update.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Records relating to people's future care wishes were not always clearly documented in a way that supported coordinated care. 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. In 3 of those records, no supporting DNACPR documentation was available. As a result, information relating to people's future care wishes was not consistently recorded or identifiable through the clinical coding used to communicate important care and treatment preferences with other healthcare providers, including paramedic and out-of-hours services.

The lack of accurate and supported recording of future care decisions meant staff and external services could not be assured they had access to reliable information about people's wishes in urgent or changing circumstances. This reduced the service's ability to support people to plan ahead and ensure their future care preferences, including decisions about resuscitation and end-of-life care, were clearly documented and available to those involved in their care.