Thomas Linacre Centre

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• 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 good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

The service treated patients with compassion, ensured their privacy and dignity was respected and took into consideration their specific needs.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed staff attitudes and behaviours when interacting with people that showed they were discreet, respectful and provided patients with help and emotional support at the time they needed it. Staff told us that they felt comfortable advocating for patients where they felt a concern needed to be raised, and it was clear that ensuring a good patient experience was central to their work. We saw recent examples of positive patient feedback about the care and attitude shown by staff in the breast screening unit, including one comment which said that “a daunting experience was made so much better by friendly, caring staff who put me completely at ease”. A patient we spoke to said that staff at the service were “very considerate and reassuring throughout”.

Services had protocols and policies to ensure that patients’ data was protected and had considered the requirements of inputting data into national breast screening programme systems. The service maintained the dignity of patients by ensuring appointments and examinations took place in private rooms, and that additional or observing staff were all introduced appropriately with patients’ consent to continue.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service was experienced in making adjustments for patients who needed them to ensure they could access care appropriately. The breast screening service had recently obtained funding for its main site to have specialised chairs so that patients with additional mobility needs could be moved into position for scanning more comfortably and securely. The breast screening service had also recently joined a reasonable adjustment working group with the trust’s equality, diversity and inclusion (EDI) team to improve the offer for this patient group.

The breast screening service had a cancer screening improvement lead (CSIL) whose role was to help improve access and reduce inequalities amongst patients who would be eligible for the service. The CSIL demonstrated they had considered the individual needs of various different communities, such as Gypsy, Roma and Traveller communities, asylum seekers, or people using domestic abuse refuges to improve awareness and ensure these groups were not disadvantaged in accessing care. For example, the service had used data to determine that a certain ethnic group had recently grown in population in a specific area and so worked to supply relevant literature to GPs in the area in common languages used by that group.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

This section was partly assessed using findings that apply to the whole location, which are included in the equivalent section of the outpatients report.

Leaflets contained information about various types of scans to help patients make decisions and advised that they could speak to a radiographer or sonographer by phone if they had any further questions in advance of attending. Clinic rooms and waiting areas had posters to inform patients that a chaperone could be requested. The service had an effective chaperone policy, which appropriately considered the needs of people with various cultural and religious values, patients lacking capacity, and children and young people.

We spoke to patients who had told us that they were easily able to rearrange appointments when this was needed. We also saw examples of the service ringing patients when there had been a cancellation, to offer opportunities to be seen sooner if this was preferred. Services could adjust appointment times for patients who required this for any reason. In line with national breast screening programme guidelines, the breast screening service had systems to enable patients to either temporarily or permanently opt out of future breast screening visits.

In response to national requirements for mobile breast screening units, the service had submitted a business case to replace the units at the end of their lease this year with wheelchair accessible alternatives, and the service had acknowledged this as a risk to delivery. However up to the time of inspection, patients with additional mobility needs were redirected to sites which may be less conveniently located. This was also true for patients requiring bone density scans (dual energy X-ray absorptiometry, DEXA) where the equipment and surroundings could not accommodate people using wheelchairs.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

This section was partly assessed using findings that apply to the whole location, which are included in the equivalent section of the outpatients report.

Staff told us they closely monitored people before and during any scan or procedure to check they were comfortable. They told us they would immediately pause the procedure if a person requested this or if a person experienced any pain, anxiety or discomfort, and the service had clear processes in line with national guidelines on reporting on findings in the case that only partial scans were completed.

People told us they were supported with their emotional needs. They told us staff were calm and reassuring and answered any questions they had about their scan. People spoke positively about the way staff listened to them and provided them with support and reassurance when they felt nervous or anxious about undertaking their scan procedure.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

This section was partly assessed using findings that apply to the whole location, which are included in the equivalent section of the outpatients report.

Feedback from staff about their experience and wellbeing at the service was mostly positive, with staff saying that while their work was often demanding, they felt respected and supported by colleagues and managers. The trust’s most recent staff survey data broadly demonstrated that allied health professionals as a staff group (which includes radiographers) reported more positive experiences and wellbeing than other groups. The staff sickness rate and turnover were in line with national averages. Services had systems for staff to highlight good practice and give thanks to their colleagues through their incident reporting tool.

At the service level, leaders held sessions with staff to help address their concerns following staff engagement surveys. Staff concerns had been clearly responded to, shared discussions were held, and actions agreed upon to facilitate improvement. Staff recognition awards were in use at the service, and staff had previously been nominated and won awards in recognition of their work.

Staff appraisals, or performance development reviews (PDRs), were generally completed by the appraisee’s line manager. We reviewed appraisals for staff at multiple levels and saw that they contained sufficient objective-setting and career development considerations.