Manchester Orthopaedic Clinical Services

This is the first time we have rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well.
• Staff provided good care and treatment. 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 good information.
• 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.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Staff understood the service’s vision and values, and how to apply them in their work. 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.

However:

• Leaders did not operate effective governance processes for the management of staff recruitment and training. Not all policies and procedures reflected the processes in place. Whilst staff were clear about their roles and accountabilities, there was no formal documented process to demonstrate staff had regular opportunities to meet, discuss and learn from the performance of the service.
• Leaders did not have effective systems to manage risk, issues and performance effectively. Staff did not identify and escalate all relevant risks and issues or identify actions to reduce their impact. The service did not have effective systems in place for compliance monitoring and audit of key processes, such as for patient records or staff recruitment and training.
• Mandatory training for non-clinical staff was not always complete and up to date.
• Not all staff had completed the higher level of adult safeguarding training in line with national intercollegiate guidance.
• Records for national early warning scores were not always completed accurately by staff.
• Not all staff had completed their annual appraisals.
• Routine engagement with external stakeholders was not formally documented.