Chear, Shepreth

Updated 10 November 2023

Chear, Shepreth is operated by Chear (Children’s Hearing Evaluation and Amplification Resource) Limited and is based in Royston, Hertfordshire. The service provides hearing assessments for babies, children and adults. The service is open between 9am and 5pm, Monday to Friday. The service saw 1340 patients in the year preceding our inspection; 672 of these patients were children. Patients aged over 19 are not in scope for registration with Care Quality Commission (CQC) and therefore not part of our inspection.

The service is registered with CQC to provide the regulated activity:

• Diagnostic and Screening Procedures.

The service has had a registered manager since it registered with CQC in 2013. The registered manager was the director of Chear, who is a clinical scientist in audiology. A new registered manager was appointed in December 2021. A registered manager is a person who has registered with the CQC to manage the service. They have legal responsibility for meeting the requirements set out in the Health and Social Care Act 2008.

The service was last inspected in June 2021, when it was rated Requires Improvement overall. The inspection team found a lack of formal processes and systems to maintain the overall governance of the service, including shared learning from incidents and complaints. There was also no formalised approach to identify and manage risks within the service. In addition, policies and guidelines were not reviewed and the service did not have audit processes to monitor the effectiveness of care and treatment. Mandatory training for staff was limited and staff did not manage clinical waste well. Equipment checks were not always documented.

We received information of concern in February 2023 which suggested that the service did not always have robust processes in place to ensure that clinical decisions and diagnoses were accurate. There were concerns that complaints were not always acted on openly and honestly, with learning identified and changes made to improve the service.

Updated 10 November 2023

Our rating of this service stayed the same. We rated it as requires improvement because :

• Staff were not up to date in training in key skills, such as training in infection protection and control (IPC), and health and safety.
• Staff had not completed training on recognising and responding to patients with a learning difficulty.
• Staff did not have up to date safeguarding training on how to recognise and report abuse.
• The service did not always assess risks and take measures to prevent such risks. The service did not have a fire risk assessment or Control of Substances Hazardous to Health (COSHH) risk assessments.
• The service did not manage clinical waste in line with the Health Technical Memorandum 07:01.
• The service did not always record consent in patient records or gain consent when sharing patient details with an independent body to investigate a complaint.
• The service did not always fully investigate incidents and identify learning opportunities from them.
• The service did not reference duty of candour in any of their policies and they were not always open, honest, and transparent when responding to patient complaints.
• Managers did not monitor the effectiveness of the service. The service did not have an audit programme. We did not see any evidence of clinical audits, which assessed, monitored and improved the quality of the service.
• The service did not document evidence of peer review or competency tests.
• Leaders did not run services well using reliable information systems. The service did not engage routinely with patients to seek feedback and identify improvements.
• Additional training and support was not given to the registered manager to support them in their role.

However:

• The service had enough staff to care for patients. Staff understood how to protect patients from abuse. Staff kept good care records.
• Staff provided good care and treatment. Key services were available to suit patients' needs.
• Leaders supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.

Updated 26 July 2021

We have not previously rated this service. We rated it as requires improvement because we rated safe and well led as requires improvement and caring and responsive as good. We do not rate effective for diagnostic imaging services.

Updated 10 November 2023