27 February 2018
During a routine inspection
Hyperbaric Medicine Unit is operated by QinetiQ Group Plc. The service has one static Type A decompression chamber with an arched doorway into the main chamber to make access easier for patients. The unit is a category one facility, which allows for patients requiring intensive care support to be treated within the chamber. The chamber can accommodate five people sitting or two lying down or three sitting and one lying down.
Facilities include a two bedded clinical assessment area, helicopter landing site to allow for HM coastguard or air ambulance to quickly transfer patients to the unit and critical care support.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 27 February 2018. Due to the nature of the service, we did not conduct an unannounced inspection.
To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
Services we do not rate
We regulate hyperbaric oxygen therapy services but we do not currently have a legal duty to rate them when they are provided as a single specialty service. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.
We found the following areas of good practice:
There were excellent processes and procedures for ensuring the delivery of safe, effective, high quality care. A range of standard operating procedures existed. Importantly, staff were well-versed and knowledgeable about the content of the operating procedures.
The service was staffed and supported by a range of health-care professionals who were competent and knowledgeable.
Patients were carefully risk assessed before they commenced therapy sessions. A comprehensive pre-assessment review was undertaken during which risks and benefits of therapy were discussed, as well as addressing queries and concerns raised by patients and their relatives.
The unit was visibly clean and well maintained.
Whilst there had been no incidents reported during the preceding twelve months, staff were well aware of their roles and responsibilities in regards to the reporting of, and learning from incidents.
There existed a flat hierarchy, which promoted a mutual respect amongst all health professionals. Individuals knew about their own professional accountabilities and responsibilities but they were also respectful of the roles of others within the team.
The management team promoted an open culture within the service allowing for staff to be candid with one another. There was a focus on learning and service enhancement and improvement.
The Hyperbaric Medicine Unit was a centre of research and was striving to participate in as many research opportunities that capacity and time allowed. There was recognition of the role research played in regards to hyperbaric therapy, especially in the case of elective patients who were referred with chronic conditions.
The service was responsive to the needs of its patients. The environment was fit for purpose with reasonable adjustments having been made to ensure the needs of the whole population could be met.
However,
The provider should look to further enhance its management of risk by ensuring areas such as risk assessments are routinely reviewed and considered within the team governance meeting.
The provider should look to extrapolate service level information from the staff engagement survey to enable exploration of any themes or trends, which may be applicable to the Hyperbaric Medicine Unit.
Amanda Stanford
Deputy Chief Inspector - Hospitals, London and South (Interim)