Cheshunt Minor Injuries Unit

Updated 13 January 2023

• Cheshunt Minor Injuries Unit is provided by HUC supported by a sub-contract with Hertfordshire Community NHS Trust. HUC is a Social Enterprise; a not-for-profit organisation with no shareholders and where any surpluses are re-invested into the service. The headquarters for HUC is in Welwyn Garden City, Hertfordshire. The service is commissioned by Hertfordshire and West Essex Integrated Care Board (ICB).
• The address of this service is King Arthur Court, Cheshunt, Waltham Cross, Hertfordshire, EN8 8XN. The website address is www.cheshuntmiu.nhs.uk.
• The service is registered with the CQC to provide the following regulated activities:
• Treatment of disease, disorder or injury.
• The minor injuries unit provides a walk-in service which is available to all patients aged one and over and has full wheelchair access. It is a nurse led service and sees approximately 505 patients a week. The service can treat a range of minor injuries from cuts, burns, scalds to a suspected fracture. The service does not treat minor illnesses or children under one year of age. The service shares the premises with Cheshunt Community Hospital.
• Clinical staff members are employed by Hertfordshire Community NHS Trust. Administrative staff are employed by HUC.
• At the time of the inspection the service team consists of 1 interim matron, 6 emergency nurse practitioners, 1 nursing associate, 2 emergency medical technicians, 1 lead administrator and 4 reception staff members.
• Cheshunt Minor Injuries Unit is open from 8am to 8pm daily, including weekends and bank holidays. The x-ray service is managed and provided by Alliance Medical and is open from 9am to 7pm Monday to Friday and 9am to 6pm at weekends and bank holidays for referred patients.

Updated 13 January 2023

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Cheshunt Minor Injuries Unit on 9 November 2022 as part of our inspection programme. This was the first inspection undertaken at this service since it was registered with this provider.

There was no Registered Manager in place at the time of inspection due to recent changes in staff management, however the provider had submitted applications to update their registration and these applications were in progress. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• There were clear systems to keep people safe and safeguarded from abuse.
• There were clear and effective processes for managing infection prevention and control.
• The service had systems for appropriate and safe handling of medicines, however joint processes in place for administering medicines without prescriptions required strengthening.
• The provider had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The provider routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• The service used key performance indicators to monitor performance and improve outcomes for people.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The service organised and delivered service to meet patients’ needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The way the service was led and managed promoted the delivery of high-quality, person-centred care.
• Leaders and staff had a commitment to improve.

The areas where the provider should make improvements are:

• Improve induction monitoring processes for temporary and permanent staff.
• Maintain sufficient staffing levels to deliver safe care and treatment.
• Continue working with partner organisations in taking action to reduce health, safety and security risks.
• Continue with plans to develop, implement and monitor locally owned Patient Group Directions.
• Strengthen systems and processes with partner organisations to ensure clear responsibilities, roles and systems of accountability for staff.
• Review ways to ensure staff have a clear understanding of and contribute to the vision and strategy of the service.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services