Archived: Dudley Cancer Support

Updated 26 May 2017

We carried out an announced comprehensive inspection on 4 January 2017 with an unannounced visit on 18 January 2017. The inspection team consisted of two CQC inspectors. The lead CQC inspector had access to advice from an oncology specialist adviser.

Before visiting, we reviewed information that we held about the service and data sent to us by the provider. This information included patient and staff questionnaires, mandatory training modules and attendance rates, and caseload figures. We used information gathered on the recent inspections of LymphCare UK’s two other locations. This was because the managers, administration staff and nurses worked across all three locations but were not specifically based at one clinic. This information included staff records, as these were held at the provider’s main location that had been inspected prior to this location’s inspection. We asked other organisations to share what they knew about the service. While on-site, we spoke with the clinical directors and nursing staff. We observed how patients were being cared for and we spoke with those patients who shared their views and experiences of the service they received.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 26 May 2017

We carried out an announced comprehensive inspection on 4 January 2017 to ask the service the following key questions: Are services safe, effective, caring, responsive and well-led? There are no ratings for this inspection, as we do not currently rate community independent health services.

Background

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

LymphCare UK is a community interest company and a social enterprise that provides comprehensive community lymphoedema services in Dudley and Sandwell. The clinic, located in a Dudley Cancer Support building, is one of three locations where LymphCare UK provides a service. The service also provides home visits for patients that are housebound or have limited mobility. LymphCare UK leases the clinic space from Dudley Cancer Support and is a separate organisation. Dudley Cancer Support provides cleaning services, and the Dudley Cancer Support Health and Safety Officer and first aiders cover the LymphCare UK clinic space as part of the lease agreement. Some patients of LymphCare UK can also register with Dudley Cancer Support to access complimentary therapies and transport services.

The service accepts referrals from any healthcare professional across Dudley and Sandwell. It provides care to patients with all types of lymphoedema, primary or secondary, from chronic oedemas to lipoedema. Lymphoedema is a long-term condition of fluid (lymph) retention and tissue swelling (oedema) in the limbs caused by a compromised lymphatic system. The lymphatic system is a part of the circulatory system and is a network of vessels that drains excess fluid from body tissue. Lipoedema is a long-term condition where there is an abnormal build-up of fat (lipid) cells.

LymphCare UK is a specialist nurse-led lymphoedema service. The leadership team consists of two managing directors who are clinical nurse specialists within the service. This team interacts with both the operational and executive boards. There are 11 members of staff employed by LymphCare UK, including the two clinical directors, nursing staff and administration staff. Four of the nurses provide a service from this location.

The clinic at this location is very small. It consists of a small treatment room and a very small waiting area with rest room facilities, and operates from the basement of premises owned by another organisation. These areas rented by LymphCare UK are solely for the use of LymphCare UK patients with a separate external entrance to the main building. There is a separate access for staff to enter the treatment room internally from the main building. There is no office or reception at this location. The service is open Monday to Friday, 9am until 5pm and runs approximately 20 clinics each month.

We gathered information from a number of sources, including data provided by the clinic before our inspection. During our inspection, we visited all areas of the clinic and spoke with nurses and two registered managers for LymphCare UK. We also spoke with patients using the service. We reviewed the staff folders on a recent inspection of LymphCare UK’s main location. This was due to staff working across all three locations and the staff folders being located at the main location.

Our Key Findings:

• Patients received safe care and treatment in a suitable environment.
• Staff felt supported in their role.
• Staff treated patients and their families with dignity and respect.
• Staff responded to each patient to meet their individual needs.
• The management team met regularly to review and monitor risks.
• Leadership was clear and open and the managers were accessible to staff and patients.
• The senior management team sought feedback from patients and made improvements from this feedback.

We identified regulations that were not being met and the provider must:

• Ensure that staff maintain an accurate, complete contemporaneous record in respect of each patient and that they keep this information up-to-date.
• Ensure written consent is documented correctly and clearly in patient notes.
• Ensure there is a local risk register in place to provide overview of local risks.
• Ensure all staff are up to date with basic life support training.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review the data capturing for mandatory training to ensure all staff training is recorded and kept up-to-date.
• Review the incident reporting process to ensure all reported incidents are collated.