Archived: The Lodge Clinic Mary Stevens Hospice

This report describes our judgement of the quality of care at this location. We based it on a combination of what we found when we inspected and from all information available to us, including information given to us from people who use the service, the public and other organisations.

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

• Staff were clear on incident reporting and could describe feedback and learning that had been shared.
• Staff were aware of duty of candour, and the requirements of being open and honest to patients.
• Staff adhered to infection prevention practice and the environment was visibly clean.
• Electrical equipment was safe to use. Service date labels were clearly visible.

However;

• Record keeping for patients’ notes was inconsistent and was not always easy to follow.
• Staff personal folders were not consistent. Information such as references, appraisal forms were missing and were not up to date.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

• Staff worked well together as part of a multidisciplinary team to coordinate and deliver patient’s care and treatment effectively.
• Staff were committed to working collaboratively with external organisations in order to deliver joined up care for lymphoedema patients.
• Staff were provided with support in the form of appraisals, supervision and role specific training to carry out their roles effectively and competently.
• Patients told us staff gained consent prior to treatment.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

• The staff we spoke with were dedicated, compassionate and enthusiastic about the service they delivered.
• Patients told us that staff always maintained their privacy and dignity.
• Staff were polite, friendly and supportive.
• We saw episodes of patient care during our inspection where staff were courteous to patients.
• Staff spoke with patients in a kind and polite manner and introduced themselves by name prior to consultation.
• Patients were empowered with educational teaching sessions regarding their treatment choices.
• The service were in the process of planning a supportive peer groups called the “Living with Lymphoedema Group” to enable patients to feel empowered.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

• The service had a good understanding on how to handle complaints and the complaint rate was significantly low.
• Patients had access to translation services if English was not their first language.
• Clinic provided us with their targets for referral to treatment times for patients seen in less than 18 weeks.
• Patients were able to choose their clinic destination and timings, including home visit if patients had limited mobility.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

• Staff were familiar with the vision and strategy for the service.
• Staff told us they felt comfortable in raising concerns.
• Staff were openly proud to work for the service and voiced how passionate they felt about providing good care for their patients.
• Staff felt the service provided an open and honest culture.
• Innovative practice was evident within this service.

This report describes our judgement of the quality of care at this location. We based it on a combination of what we found when we inspected and from all information available to us, including information given to us from people who use the service, the public and other organisations.