• Doctor
  • Independent doctor

Highfield ENT Clinic

Overall: Good read more about inspection ratings

Highfield Hospital, Highfield Road, Widnes, Cheshire, WA8 7DJ (0151) 511 5732

Provided and run by:
Widnes Highfield Health Ltd

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Highfield ENT Clinic on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Highfield ENT Clinic, you can give feedback on this service.

11 November to 19 November 2021

During an inspection looking at part of the service

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced focused inspection at Highfield ENT Clinic as part of our inspection programme to follow up on breaches of regulations. The key question we inspected was:

Effective.

CQC inspected the service on 4 March 2019 and asked the provider to make improvements regarding Regulation 11 HSCA (RA) Regulations 2014 Need for consent. We checked this area as part of this focused inspection and found this had been resolved.


Highfield ENT Clinic is operated by Widnes Highfield Health Ltd. The service holds a contract with Warrington and Halton NHS Trust to provide an ear, nose and throat service. This service is delivered by hospital consultants and a specialist ear care nurse. The clinic provides the service to children from two years of age and adults who are registered with a Halton GP Practice.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Highfield ENT Clinic provides a range services and treatments, for example ear wax removal, hearing aid tests and electrocardiogram (ECG) which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Dr Paul Lawrence is the registered manager. 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:

  • The provider had addressed the breach of regulation 11: consent. Consent was monitored through audit and appropriate actions were taken.
  • The provider had made improvements to policies for complaints, duty of candour and safeguarding to meet legislation.

The areas where the provider should make improvements are:

  • Review the level of safeguarding children training undertaken by nursing staff as detailed in the Intercollegiate Document @Safeguarding Children and Young People : Roles for Healthcare Staff.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care

4 March 2019

During a routine inspection

Highfield ENT Clinic is operated by Widnes Highfield Health Ltd. The service holds a contract with Warrington and Halton NHS Trust to provide an ear, nose and throat service. The service employs two ear care nurses that provide nurse led clinics during the week, and one health care assistant. There are two consultant led clinics provided two days per week, and the consultants are employed by Warrington and Halton NHS Trust. The service takes referrals from GPs and aims to see patients within two weeks of referral. The service accepts both adults and children, however the numbers of children seen are low.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit on 4 March 2019. The consultants were not providing clinics on the day of inspection, and there was one ear care nurse on duty. We spoke to the ear care nurse, health care assistant, administrative staff and the registered manager. We spoke to three patients who attended the clinic.

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 rate

The service has not previously been inspected or rated.

We found the following areas of good practice:

  • The service provided a wide range of mandatory training and had systems in place to ensure this was completed.

  • Staff understood their safeguarding responsibilities and information was shared during team meetings and on the staff bulletin.

  • The service used an electronic system for patient records which meant staff, patients and GPs had access to important information when they needed it.

  • There were enough staff who were competent in their roles and had good support and mentoring from managers.

  • Staff treated patients with compassion and patients’ dignity and privacy was respected.

  • The service established good links with the local area to help plan the service to meet the needs of local people.

  • The service had clear admission and exclusion criteria.

  • The service could offer patients an appointment within one to two weeks of referral and patients did not have to wait long in the waiting area.

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

  • There was not always a suitable clean space for cleaning used equipment. This could pose a risk to the spread of infection. The service amended this immediately.
  • Paper records were not always completed in line with best practice guidance. This was because entries were not always signed by the person making the entry which was not in line with the Royal College of Physicians record keeping standards 2015.
  • The consent policy was not in line with general medical council guidance, putting both patients and staff at risk of not having proper discussions about treatment or documenting consent. It is important for patients to be fully informed of the associated benefits and risks, before agreeing to treatment. However, when we discussed this with managers the service amended the policy immediately.
  • Although the provider had a duty of candour policy this did not fully meet national guidance or legislation as it did not outline the relevant person should be notified of a moderate harm safety incident in writing.
  • The service did not monitor outcomes of care and treatment. This meant the service missed opportunities to identify where the service could improve.
  • The service did not have a system to highlight individual needs such as whether a patient had a sensory impairment or disability. The service was reliant on the GP referral form for information. This meant the service may not effectively plan for and meet the individual needs of patients.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and 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 three requirement notice(s). Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals