Archived: Wren Healthcare Limited

Updated 8 April 2022

Wren Healthcare Limited provides specialist nurse-led clinical homecare services. The service provided clinical homecare nationally and had nursing staff across England and Wales.

Clinical homecare is a term used to describe care and treatment that takes place in a person’s own home. The aim of clinical homecare is to minimise the need for patients to attend an acute hospital setting for their treatment.

The service was working on a non-exclusive basis in partnership with two charity organisations who provide donor matches for patients with blood cancers requiring stem cell blood transplants. The regulated activities were relevant to the nurse-led services in people’s homes that involved phlebotomy, patient training in self-administration and drug administration of granulocyte colony stimulating factor (G-CSF), on call clinical support, remote visits and monitoring observations. The service was also accredited to provide eXroid electrotherapy to patients in their homes with up to grade three haemorrhoids, which is an alternative to banding for patients with grade one or two haemorrhoids, and as an alternative to surgery for patients with grade three or four haemorrhoids.

The service registered with the Care Quality Commission in 2018. They are registered to provide the following regulated activities:

• Treatment of disease, disorder, or injury
• Diagnostic and screening procedures

Wren Healthcare Limited also has a team of specialist research nurses that support clinical trial patients in their home including providing specialist training to clinicians and carers. The service’s clinical skills academy provides continual professional development (CPD) accredited courses including clinical skills and disease area training to professionals across healthcare settings. The service is also Government registered to carry out COVID-19 testing including fit-to fly testing for travellers with clinics across Essex, Kent, Southampton, Surrey and London, which is regulated by The United Kingdom Accreditation Services (UKAS). We did not look at these services as the Care Quality Commission (CQC) does not regulate these activities.

At the time of this inspection the service had a registered manager.

At the time of this inspection the service had ten permanent clinical homecare nursing staff and six bank staff delivering clinical homecare services to patients. The service had five staff in induction training.

We had not inspected this service before.

Updated 8 April 2022

Wren Healthcare Limited is a provider of specialist nurse-led clinical homecare services across England and Wales.

We rated this service as good because:

• The service had enough staff to care for patients. They accepted referrals based on whether they had staff to provide care in a timely manner and keep people safe.
• Staff had training in key skills, understood how to protect people using the service from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. Staff completed clinical competency assessments for phlebotomy and subcutaneous medicine administration. The service managed incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• The service used systems and processes to administer and record medicines safely. They did not store any medicines.
• The service held monthly partner meetings with referring organisations, which detailed the service specific requirements. The referring teams were responsible for monitoring the effectiveness of treatment and patient outcomes and the service worked effectively with these external teams to provide good care and benefit people using the service.
• The service provided good care and treatment based on national guidance and evidence-based practice. Staff protected the rights of patients in their care and supported them to make informed decisions about their care and treatment. The service made sure staff were competent for their roles.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their treatment. They provided emotional support to people using the service. The patients we spoke with were happy with their care and described the service as “brilliant” and “professional”.
• The service provided care to meet the needs of the communities it served. It also worked with partner organisations to plan care. The service was inclusive and took account of patients’ individual needs. People could access the service when they needed it and received the right care in a timely way. It was easy for people to give feedback and patients we spoke to told us they felt confident to raise concerns about the care received.
• Managers were approachable, supportive, and had the skills and knowledge to ensure patients received a quality service. Staff understood the services’ visions and values, and how to apply them to their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care and were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• The service did not have a formal supervision policy. Staff told us they received one-to-one meetings with their managers and clinical supervision was being carried out, although the frequency of structured managerial supervision was inconsistent. The service was in the process of developing an overarching supervision policy that would include both clinical and managerial supervision, however this was not yet embedded in practice.
• Managers did not complete infection prevention and control (IPC) audits. However the service provided an audit schedule detailing IPC audits which were due to commence in March 2022. In the week following our inspection the service brought this forward and completed an IPC audit and shared outcomes with us. Field visits were also being completed which assured managers that staff were delivering safe care to patients.
• The service was not undertaking annual appraisals with staff in line with their policy. However, the service had a clear strategy for how this would be embedded with objective setting meetings completed for all staff by the end of March 2022.

Updated 8 April 2022