We found that there were suitable systems in place to gain consent from patients. Staff who obtained consent were experienced and knowledgeable in their field of expertise. Patients told us they were treated with respect and given plenty of good information in order to make an informed decision regarding care and treatment. Patients told us:

“We get lots of good information, everything is explained to us and I have read all about it in the booklet.”

“It’s fantastic here, the staff are brilliant.”

“It’s very good; they are very courteous and very professional.”

We found that patients' care and treatment was assessed, planned and delivered in order to meet their needs. Care and treatment plans were fully documented and reviewed and patients were fully informed and involved in their care or treatment.

Staff were inducted, trained and supervised appropriately and told us they were well supported by the management team.

We found the provider had systems in place for monitoring the quality of services. Audits were undertaken across the unit, there was a complaints process and patient satisfaction surveys were undertaken. Audits were not effectively used to monitor quality and to improve on the service provided.

We found the provider maintained accurate records that were stored securely and accessible.

There was a small team of staff at the centre who worked well together. We found the medical director, the facility manager and the hyperbaric nurse to be knowledgeable and skilled. They had a positive ethos towards good quality care. Both the medical director and facility manager were visible and approachable.

We found emergency access to the service was good. Staff could be called in and the unit opened within an hour. The average wait from referral to treatment was six weeks. We found this to be comparable with the average wait for treatment in other such units. Staff at the hyperbaric unit were compassionate and caring. They were aware of the experience for patients and were very supportive to people who were anxious and did not just take their hyperbaric treatment in isolation. The timing of the morning and afternoon sessions meant that patients did not have to travel very early or return home late. There was flexibility for elective patients to attend sessions to fit in around their own routine.

There were clearly defined vision and values for Murrayfield Hyperbaric Treatment & Training Services Limited. Staff understood their role in achieving the vision for the service and there was a pathway to monitor progress towards delivering goals. Staff told us they received an annual appraisal, this was confirmed by the records we reviewed. Records also confirmed that there were regular, staff meetings. Staff reported that they could be involved in developing the service through these meetings.

There was a strong focus on patient safety. Appraisal for Accreditation and Membership by the British Hyperbaric Association (BHA) was undertaken in February 2015.  Maintenance records indicated staff carried out safety checks on a daily, weekly and monthly basis, for example, the oxygen and carbon dioxide levels within the chamber, was checked daily.  However, we found the resuscitation equipment inside the chamber such as the medicine and airway bag were only checked on a weekly basis.