People who used the service were given appropriate information and support regarding their care and treatments. Information leaflets about the hyperbaric unit and treatments were available. Policies and procedures were in place to ensure that all people who used the service were safeguarded against the risk of abuse

People's needs were assessed and care and treatment was planned and delivered in line with their individual needs. Treatment was provided in a hyperbaric chamber for a wide variety of conditions, for example, decompression illnesses, gas embolisms, carbon monoxide poisoning and severe tissue damage.

There were enough qualified, skilled and experienced staff on duty to meet people’s needs. And to cover the working day from 8.30am until 5pm. The provider had an effective system to regularly assess and monitor the quality of the service people received.

We spoke to a person who had just attended his third session in a chamber. He told us that he was initially referred to the unit through the NHS. He said that the whole procedure was explained to him at the first session. He confirmed that he was seen and consulted about his conditions every time he attended the clinic. He felt quite respected at the unit, where he knew staff and they knew him by his name. Staff were very polite and supportive to him, respecting his time for preparation. He confirmed that cleanliness was always appropriate and that the dressing gown given for the procedure was always clean.

He did not need to eat during his sessions, but was always offered an appropriate drink. He felt that his treatment was successful and he was quite happy with the treatment received.

London Wound Healing Centres Ltd have provided the service at the East of England Hyperbaric Unit since 2007. We inspected the service on 17 & 18 September 2015. The hyperbaric unit was located within the James Paget University Hospital in Gorleston-on-Sea, Norfolk. The unit provided hyperbaric (high-pressure) oxygen therapy for a range of conditions. The service was available to NHS and private patients of all ages.

We carried out this inspection as part of our pilot phase for independent health care cares services. There are CQC inspection frameworks for single speciality (SS) services such as hyperbaric services which were being tested in wave 1 (April 2015 – September 2015). Until October 2015 we were in the pilot phase for the SS services list and therefore we will not publish a rating for the East of England Hyperbaric Unit.

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?

Services were safe. Staff paid careful attention to all aspects of safety. They were aware of safeguarding procedures and training completion was checked as part of the appraisal process. There were high standards of cleanliness and equipment was appropriately checked and maintained, with detailed attention to safety. Medical records were comprehensive. Staff assessed and took into account risks to individual patients. The unit was fully staffed and had access to additional specialist support.

Are services effective?

The service was effective. Due to the specialised nature of the service there was no national bench marking, but we saw that patients were fully assessed and treatment was based on best practice. Patients told us that they were pleased with their health outcomes. The service followed up on their progress after completion of their treatment. Patients were kept well hydrated. Appropriate regard was paid to the requirements of the Mental Capacity Act. Staff were experienced, well trained and well supported. 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?

We found the staff at the hyperbaric unit to be compassionate and caring. Care and treatment was provided in a friendly, kind and considerate way. All staff were approachable. They provided clear explanations of the procedures to patients. Staff were ready to discuss patient’s treatments with them and involve them and (where appropriate) their families in decisions about care and treatment. Staff provided empathetic support to families as well as to the patients.

Are services responsive?

We found the service responsive to the needs of patients it treated. Treatment schedules for non-emergency patients took their individual circumstances into account. Rapid access to treatment was provided, especially for emergencies, when the unit could be opened within about an hour. Patients told us that they received prompt appointments and there was no delay in their treatment when they arrived at the unit. Cancellations were rare. The service was patient-centred and encouraged feedback. A complaints policy was in place, but no formal complaints had been received.

Are services well led?

The service was well led. Strong clinical and professional leads were provided by the medical director and the registered manager (who was the managing director). Staff shared a strong commitment to providing the best possible service to patients. Risks were assessed and action taken to reduce them. The quality of the service was carefully monitored. Senior managers carried out audits and areas for improvement were identified and tackled. There was an open and honest culture. Feedback from patients and staff was encouraged and was used to improve the quality of the service. Investment was made in equipment to further improve the service and the service participated in national research. Problems such as enabling rapid access to the service for critically ill patients were being tackled.

Our key findings were as follows:

• The service was well equipped and well maintained, with careful attention to all aspects of safety.
• 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 clinical lead and registered manager provided a strong lead and team working was effective.

Professor Sir Mike Richards

Chief Inspector of Hospitals