Poole - Atlantic Enterprise UK Limited t/a The Diver Clinic

Atlantic Enterprise UK Limited, trading as The Diver Clinic, has provided a service to NHS patients in Poole since 1992. We inspected the service on 15 December 2015. The hyperbaric unit is located in the centre of Poole in Dorset, close to local diving centres and the local acute NHS hospital. The unit is commissioned to provide hyperbaric (high-pressure) oxygen therapy for divers with conditions requiring compression. The service is available to NHS patients of all ages.

We carried out a comprehensive inspection of this service. The team inspected the full hyperbaric service against criteria to judge whether treatment and care was safe, effective, caring, responsive and well-led.

Are services safe?

Patients were protected from the risk of abuse and avoidable harm. There were processes for reporting and learning from incidents. The clinic was visibly clean and there were good infection prevention and control practices to reduce the risk of infection. Patients were assessed to make sure only those that were suitable received treatment at the clinic. Patient risks were reviewed and patients were appropriately monitored during their treatment. Staff were aware of processes to follow in the event of an emergency. Equipment was well maintained and tested in line with manufacturer and national guidance. Medicines were managed in a safe manner. An on call rota ensured staff numbers and skill mix met the needs of patients and complied with the national guidelines.

Are services effective?

Patients were fully assessed and treatment was based on best practice. Staff had access to the information they needed to provide effective treatment. Patients were pleased with their health outcomes. They were provided with clear information, for example about potential side-effects, and the service followed up on their progress following treatment. Patients were kept well hydrated. Pain relief was available if required. Appropriate regard was paid to the requirements of the Mental Capacity Act 2005. Staff were experienced, well trained and well supported through training and appraisals. There was strong team working, including with other agencies. Emergency treatment was available 24 hours a day, every day of the year

Are services caring?

Patients and relatives commented positively about the care provided from all staff, describing the care as “excellent.” They said staff took consideration to protect their privacy and dignity. Patients were fully involved in making decisions about their treatment, having full explanations about the proposed treatment and any associated risks explained to them. Staff considered the emotional needs of patients. Patients expressed that staff made them feel at ease during the course of treatment. There was consideration of patients particular needs after treatment was finished. Staff ensured patients had transport to take them home or arranged accommodation at local guest houses to alleviate concerns with getting home during the night.

Are services responsive?

The clinic provided a 24 hour, seven day on call emergency service with patients commencing treatment within two hours of referral. The service was patient centred, and feedback was positively encouraged. Changes were made to the service in repose to patient feedback in order to improve patient experience. A complaints policy was in place, but no complaints had been received.

Are services well led?

Strong clinical and professional leads were provided by the medical directors, managing director and the registered manager. All the members of the team with whom we spoke shared a strong commitment to providing the best possible service to patients which reflected the clinics stated mission. The quality of the service was monitored. Risks were assessed and action taken to reduce them. There was an open and honest culture. Feedback from patients and staff was encouraged and used to improve the quality of the service.

Our key findings were as follows:

• The service was well equipped and well maintained, with careful attention to all aspects of safety.

• The service provided resulted in good outcomes for patients.

• The staff at the hyperbaric unit were compassionate and caring.

• The service was appropriately staffed with well qualified doctors, nurses and technical staff, and was responsive to patient’s individual needs.

• The directors and registered manager provided a strong lead and team working was effective.

In addition the provider should:

• The provider should consider revising policies to make them fully relevant to the clinic’s practices.

• The provider should consider copying patients into discharge letters sent to their GPs.

Professor Sir Mike Richards

Chief Inspector of Hospitals