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Provider: Healogics Limited

Inspection Summary


Overall summary & rating

Updated 22 June 2017

We found the following areas of good practice:

  • Staff treated patients with kindness and compassion at all times. We saw staff involved patients in decision making about their care.

  • There was evidence of multidisciplinary working within the organisation and with external agencies such as local community health providers.

  • There was evidence of incident reporting and dissemination of lessons learned.

  • Staff had the appropriate skills and knowledge for their roles.

  • The organisation actively supported staff to develop and extend their knowledge and competencies, and encouraged innovation.

  • Staff were supported with strong local leadership. Staff felt valued and had a clear understanding of the organisations vision and strategy.

  • The provider was flexible and delivered care to meet the patients’ needs.

  • Complaints were treated fairly and with compassion and taken seriously.

However:

  • The provider did not meet its mandatory training rate targets for several training modules including safeguarding and infection control.

  • Patient records were not always complete, and staff did not always record patient information or their rationale for treatment decisions.

  • The Eastbourne clinic raised concerns about patient access and privacy. The provider was aware of the Eastbourne clinics limitations. At the time of inspection they had identified a site for a new clinic and they report they moved locations in May 2017. Therefore information specific to the Eastbourne site may not be applicable. However, we are required to report on what we saw on the day of inspection and unable to report on a site we have not seen.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Inspection areas

Safe

Updated 22 June 2017

Summary

  • There was a positive, no blame culture towards incident reporting and we saw evidence of learning from incidents. Staff understood their responsibilities under the duty of candour regulation.

  • The environment and equipment at all of the sites was visibly clean and well maintained.

  • There were systems, processes and standard operating procedures that were reliable and kept patients safe.

  • Staffing levels were planned according to the amount of patients requiring care and treatment and we saw sufficient levels of staffing throughout our inspection.

  • We saw the provider had systems in place to assess and respond to anticipated risks.

However:

  • Mandatory training compliance, including Safeguarding and Infection Prevention and Control, was worse than the providers 100% target. Hand hygiene audits were worse than the provider’s target.

  • Moving and handling risk assessments had not been completed for some high risk staff activities.

Effective

Updated 22 June 2017

Summary

  • Services were delivered in-line with current national guidelines and were monitored to ensure compliance.

  • Patients had comprehensive assessments of their needs and were included in decision making and wellbeing.

  • We saw evidence of effective multidisciplinary working; teams worked collaboratively to understand and meet the range and complexity of people’s needs.

  • Appropriate awareness and training in the Mental Capacity Act and consent was seen and staff understood their roles in relation to this.

However:

  • Not all staff had a current appraisal due to a recent change in appraisal methodology.

  • Staff did not always update patient records to reflect the reason for clinical decisions.

Caring

Updated 22 June 2017

Summary

  • Feedback from patients and their relatives was continually positive. We witnessed staff gave patients the time to listen to their concerns and offered support where needed.

  • Staff explained and ensured that patients and carers had a good understanding of procedures before undertaking them.

  • Staff showed kindness and compassion, they respected patients dignity at all times and were sensitive to patients’ needs.

However:

  • Privacy and dignity could not be maintained in the bay area of the Eastbourne clinic.

Responsive

Updated 22 June 2017

Summary

  • The provider was flexible and delivered care to meet the patients needs.

  • There was continuity in patient care. Patients generally saw the same staff members who knew them and their care needs.

  • The needs of patients were considered and used to make changes to the service. Urgent needs were catered for and waiting times and delays were minimal.

  • Staff were able to schedule appropriate time for each patient dependent on their needs, and understood that when more time was needed adjustments could be made to ensure appropriate care was given.

  • Complaints were treated fairly and with compassion and taken seriously.

However,

  • Patients without carers may not have the same access to care as patients with carers if they cannot transfer from a wheelchair to treatment couch independently.

  • Patient complaints, comments and feedback were not defined and staff demonstrated lack of clarity about how to classify patient comments. This could result in patients’ concerns not being classified and responded to appropriately

Well-led

Updated 22 June 2017

Summary

  • There was a clear governance structure with communication to the executive team. Staff felt supported by their line managers and felt confident to raise concerns with them. There was a strong visible local leadership who together with the staff were committed to improving patient care.

  • We saw staff and managers shared the same vision and strategy and staff survey results reflected this.

  • Risks were regularly reviewed by the senior team and staff were able to describe the risks to the organisation.