Sellindge Surgery

Updated 7 November 2017

• Sellindge Surgery (the service) is an NHS funded community ears, nose, and throat (ENT) outpatients clinic and is operated by Sellindge Practice Limited. The service opened in 2011 and sees and treats patients aged two years and over with an ear, nose or throat problem that are registered with a GP practice within Ashford, Canterbury, South Kent Coast, Thanet or West Kent CCGs.

• The service is delivered from a purpose built premises in the village of Sellindge, Kent. Patients are able to use the public car park next to the practice and patient areas are accessible to patients with mobility issues. Only NHS patients were seen at this service.

• The service primarily serves the communities of Kent and also accepts patient referrals from outside this area.

• There were two general practitioners working at the service under practising privileges.

• Regulated activates include; doctors consultation and treatment service and diagnostic and treatment services.

• The registered manager is Dr George Vattakuzhiyi and has been the nominated individual since March 2013.

• In the reporting period October 2015 to September 2016 there were 1,924 NHS funded outpatient attendances recorded at the service. Of these attendances 229 (12%) were children aged between three and seventeen years of age.

• Due to the increase in referral numbers to the service over the years there were four sessions every week, two sessions on a Thursday afternoon and one session on a Friday morning and Friday afternoon. The service occupies the same two GP Surgery consulting rooms for each clinic. The service shares the reception and waiting area with the GP surgery patients.

• This service had been previously inspected in 2014 for the provision of NHS funded ENT outpatient activities and were advised to improve on areas of staff involvement, record keeping of staff training and discussion from the results of patent surveys.

• There were no never events, no clinical incidents and no incidents of Meticillin –resistantstaphylococcus aureus (MRSA) Meticillin-sensitive staphylococcus aureus (MSSA) or Clostridium difficile (C.diff).

• There was one complaint about this service in the reporting period.

Updated 7 November 2017

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 23rd March 2017. The service is an NHS funded community ears, nose, and throat (ENT) outpatients clinic and is operated by Sellindge Practice Limited. The service opened in 2011 and sees and treats patients aged two years and over with an ear, nose or throat problem that are registered with a GP practice within Ashford, Canterbury, South Kent Coast, Thanet or West Kent CCGs. Only NHS patients were seen and treated at this service.

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.

We found the following issues that the service provider needs to improve

• We saw the medical practitioner was not bare below the elbow and did not demonstrate an appropriate hand washing technique in line with ‘five moments for hand hygiene’ from the World Health Organisation (WHO) guidelines on hand hygiene in health care.

• We found safety tests on a nasendoscope (a flexible telescope is used to look into the back of the nose) were not carried out in line with national recommendations.

• We saw consulting rooms where clinical procedures were carried out were carpeted. This meant the service was non-compliant with the Department of Health (DH) Health Building Note (HBN 00-09) Design for flooring, walls, ceilings, sanitary ware and windows which states carpets should be avoided in clinical areas to avoid contamination.

• We saw posters on hand washing were out of date and not in line with World Health Organisation (WHO) guidelines on hand hygiene in health care.

We found the following areas of good practice:

• The service had direct access to ear, nose and throat (ENT) waiting lists and ENT operating lists. This meant that patients did not have to attend the hospital for a consultation prior to a procedure and were placed on the operating list in a more effective manner.

• The service received positive feedback from patients saying they were treated with a caring attitude and were informed about their treatment.

• The service managed staffing effectively and services always had enough staff with the appropriate skills, experience, and training to keep patients safe and to meet their care needs.

• The service had a small and dedicated team, there was clear leadership and staff felt supported by their managers.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected Sellindge Surgery. Details are at the end of the report.

Updated 7 November 2017

• There was a system for reporting and recording incidents.

• Staff understood the duty of candour and understood the importance of being open and truthful.

• The service had a small dedicated team with regular staff meetings.

• Outcomes for patients were collated via patient feedback forms and patient surveys. These were all very positive.

• Complaints were addressed in a timely manner.

• The service could demonstrate compliance with National Institute for Health and Care Excellence (NICE) guidance.

• There was evidence of staff appraisals and training for the staff.

• The service received consistently high positive feedback from patients about their care. Privacy and dignity were maintained.

• The Friends and Family test showed over 95% of patients would highly recommend their family and friends to the service.

• The service was able to provide a choice of clinic days for patients to access which gave more flexibility for patient choice

• The service provided hearing test facilities for all clinics, which reduced the number of times patients had to attend the service.

• Information on how to complain was available and complaints were acted upon in a timely manner.

• Leadership arrangements were clear.

• Governance arrangements were in place with regular meetings taking place.

• The service had a risk register, which was reviewed and updated regularly.

However:

• Staff did not always follow the appropriate hand washing technique in line with ‘five moments for hand hygiene’ from the World Health Organisation (WHO) guidelines on hand hygiene in health care.

• Safety tests on a nasendoscope were not carried out in line with national recommendations.

• Consulting rooms used for clinical ENT procedures were carpeted and as such were non-compliant with the department of Health (DH) technical Memorandum (HBN 00-09).

• Posters on hand washing were out of date and not in line with World Health Organisation (WHO) guidelines on hand hygiene in health care.