Newmedica Wakefield

We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in most key skills, understood how to protect patients from abuse, and managed safety well. The service had agreed systems and processes in place to safely prescribe, administer, record and store medicines and infection risk. The service had processes to manage safety incidents and lessons learned. Records were stored securely and easily available to all staff providing care.
• Staff provided safe care and treatment and made patients comfortable when needed.
• Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to useful information.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Governance processes were in place. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients and carers.
• The service planned care to meet patients’ individual needs and made it easy for people to give feedback.

However:

Surgery:

• Staff training did not include announced and unannounced emergency simulation drills.
• Eight patient records were reviewed which showed shortfalls in information, legibility, dates, absence of staff grading and medical staff General Medical Council numbers.
• Patients’ follow up calls were not completed for all patients. Following a call when the patient was not reached there was no evidence that another follow-up call had taken place.
• We saw limited evidence that attention was given to the range of complications and the visual outcome.
• Where patients were referred post operatively to other hospitals for follow-up this was not recorded by ‘Newmedica’ as a complication which could be used to inform current practice and patient outcomes at the hospital.
• All risks should be identified on the service risk register.
• The onward referral clinical support (December 2020) document confirmed which Trust the patient would be referred to for specific concerns. Staff said this agreement was reviewed with the local NHS Trust verbally, however, no written minutes existed of these conversation

Outpatients:

• Consultant and nursing records were not completed fully.
• The service did not undertake audits for the completion of consultant and nursing records including the signing and dating of entries.
• The clinical team did not have consistent access to current information related to patients existing medical conditions and treatments.
• When an incident occurs, details are not always fully documented in the patients notes, in the patient’s electronic record or in the incident reporting system.
• Audits are not undertaken for the completion of consent information.
• Post-operative checks are not consistently undertaken for each patient.