Medway Community Healthcare C.I.C

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

Are Community urgent treatment centre responsive? This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question as requires improvement. At this assessment the rating had improved. We rated responsive as good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders ensured that care and treatment was delivered in partnership with patients and or their carers.

People were supported to receive care that reflected their individual needs, preferences and circumstances. Staff demonstrated a good understanding of the people they supported and used personalised care planning to ensure care and treatment were tailored appropriately. Care plans contained relevant information about people’s preferences, communication needs, cultural and religious considerations, and these were used consistently by staff to guide day‑to‑day care.

Staff involved people in decisions about their care and treatment wherever possible. People were encouraged to express their views and wishes, and staff listened to and respected these when planning and reviewing care. Where people experienced changes in need, staff worked with them to adjust care plans in a timely way, helping to ensure care remained responsive and appropriate.

The service empowered people to make informed choices. Information about care, treatment options and support was provided in a way people could understand, and staff took account of people’s communication needs. Where required, staff supported access to advocacy and involved those acting on a person’s behalf, in line with relevant consent and capacity requirements.

People’s diverse needs were recognised and respected. Staff were aware of protected characteristics and took these into account when delivering care, helping to promote equitable and inclusive experiences. This included making reasonable adjustments and adapting care to meet individual cultural, social and religious needs.

Care and treatment were planned and organised to meet people’s individual needs, and staff had access to clear and up‑to‑date information to support consistent delivery of care. Records showed that assessments and care plans were comprehensive and shared appropriately within the service, helping to ensure patients did not have to repeat their history unnecessarily.

The service worked well with other teams and agencies to support integration of care. This included collaboration with the acute trust, primary care, community services, specialist teams and social care, where required. Staff understood their role within the wider system and knew how and when to involve other professionals to ensure people received coordinated support.

There were effective arrangements to support continuity following a patient visit to the urgent treatment centre. Plans were developed with people and relevant professionals including the patient’s GP and social services to ensure transitions were timely and well managed. This helped reduce the risk of disruption to care and supported people to maintain progress toward their goals.

The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.

Patients could access information in their local dialect. Managers made sure staff, and patients, loved ones and carers could get help from interpreters or signers when needed. Staff had access to communication aids to help patients become partners in their care and treatment.

The service had systems to help care for patients in need of additional support or specialist intervention.

Managers monitored and took action to minimise missed appointments. Staff made attempts to contact patients when they missed their appointments to find out the reasons for the missed appointments and whether they still required care and treatment.

The service relieved pressure on other departments when they could treat patients in a day.

The service complied with the Accessible Information Standard. The Accessible Information Standard (AIS) is a legal requirement for all NHS and public funded bodies set out to ensure that people with disabilities, impairments, or sensory loss receive the information and communication support they need from NHS and adult social care services.

The service provided information in easy read format. There was a hearing loop in the waiting area. A hearing loop is an assistive listening system that transmits sound directly to hearing aids or cochlear implants, improving clarity and reducing background noise.

There was information about the service, including how to obtain information on treatments and other local services.

Staff told us that the Medway and Swale area was home to people from a wide range of backgrounds and nationalities. When required, the service provided interpreters and signers from other third-party organisations for patients and carers. Staff said they also used Google translation online.

Staff involved carers, families and their GPs about the patient’s care and treatment.

The service sought feedback from people about their experience of the service.

People were actively involved in decisions about their care. Staff encouraged people to express their views and preferences and took these into account when planning and reviewing care and treatment. Where appropriate, families, carers and others acting on a person’s behalf were involved, in line with consent and capacity requirements. This helped ensure decisions reflected what mattered most to people.

The service demonstrated an open and transparent approach to feedback and complaints. The service reported 51 formal complaints in the last 12 months prior to our assessment. Twenty of these complaints were upheld or partially upheld. Most of the patients’ complaints were related to the quality of care they had received. The service did not receive any ombudsman complaint in the last 12 months.

The service did not ensure that information on how to make a complaint to the service or other regulatory bodies such as CQC was clearly displayed and accessible to people. We saw that there were slips of paper on the unit about how to contact the service in reception areas. However, it was not clear whether this was about contacting the service to make a complaint or raise a concern. We also found that the information leaflets on how to make a complaint was in the staff rooms and not in public areas where patients and carers could access them.

Most patients said they did not know how to make a complaint to the provider. However, only one patient out of 20 patients and carers we spoke with said they would be making a complaint following their visit to the urgent treatment centre. One patient who had previously visited the service and had made a complaint in the past said that their complaint was taken seriously and handled compassionately, with no negative repercussions. They said they were kept informed about what was happening and received responses in a timely way

Staff viewed feedback, concerns and complaints as opportunities for learning and improvement. Learning from complaints and feedback was shared with staff, and staff could describe how changes had been made as a result.

The service reported 25 compliments from patients and carers in the last 12 months. Patients and carers said that staff were very kind, attentive and professional.

The service was good at making sure people could access the care, support and treatment they needed when they needed it. Arrangements were in place to help ensure timely access to services and to minimise barriers that could prevent people from receiving appropriate care.

Staff understood the different needs people might have when accessing services and made reasonable adjustments to support equitable access. This included supporting people with physical disabilities, sensory impairments or communication needs, and adapting arrangements so people could access care safely and with dignity.

The service took steps to ensure people were not disadvantaged by personal circumstances or protected characteristics. Staff were aware of equality and inclusion considerations and used information from assessments and care plans to tailor access arrangements appropriately. This helped reduce the risk of people experiencing unnecessary delays or exclusion from care.

Managers and staff monitored access to services and worked to ensure people received care within appropriate and expected timeframes. Where there were risks of delay, staff took action to prioritise care based on individual need and clinical urgency. Managers monitored did not attend (DNA) appointments and clinicians were required to follow DNAs by contacting the patient to ascertain the reason for non-attendance. People were offered another appointment within two weeks where required.

The service also supported continued access to care following discharge or transfer, working with relevant teams and services to help ensure people could access ongoing support particularly for patients on the DVT and cellulitis treatment pathway. This included liaison with community services and other agencies where appropriate, helping promote continuity and fairness in access beyond the immediate service.

The service recognised and considered people’s individual circumstances and protected characteristics when planning and delivering care.

Assessments and care plans reflected relevant needs, including cultural, social, communication and disability‑related factors, helping to ensure people’s experiences of care were fair, respectful and inclusive. This supported equitable outcomes for people with differing needs.

The service promoted a culture in which people felt empowered to share their views and raise concerns, including discrimination or inequity. Staff were receptive to feedback and demonstrated an understanding of people’s rights, including equality and human rights. People felt listened to and confident that their experiences would be taken seriously.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights.

The service was good at supporting people to plan for important life changes, enabling them to make informed decisions about their future care, treatment and support. Staff took a proactive approach to forward planning and worked with people to ensure their wishes and preferences were understood and respected.

Care and treatment planning reflected people’s individual needs, wishes and feelings, and records showed that future planning was considered as part of ongoing assessments and reviews. Where appropriate, staff supported people to think about longer‑term goals and transitions, helping them prepare for changes in their health, care needs or circumstances.

Staff supported people to make decisions about their care and treatment, including future‑focused decisions where relevant. This included involving people in discussions about options available to them and ensuring decisions were made in line with consent and capacity requirements. Families, carers and others acting on a person’s behalf were involved appropriately, helping to ensure decisions reflected people’s best interests.

The service worked collaboratively with relevant professionals and agencies to support future planning for people with complex needs. This helped ensure plans were realistic, coordinated and responsive, and that people were supported to access appropriate services when required.

Where people were approaching significant life events or required sensitive planning, staff managed these discussions with care, dignity and respect. Information was communicated clearly, and people were given time and support to consider their choices.