Enter and view is one of a range of tools available to Healthwatch Bracknell Forest to gather information needed about services and collect views of service users, their carers and relatives. Visits aim to provide an informed view of the quality and scope of health and adult social care services provided for the residents of Bracknell Forest. Recommendations for improvement will be backed by evidenced based reports.

Healthwatch Bracknell Forest will proactively seek to build good relationships with providers of health and adult social care services. Enter and view is not an inspection but instead an opportunity for laypeople to engage with vulnerable service users and their families, in order to gain a better view of how they feel about their services.

• NHS Trusts
• NHS Foundation Trusts
• Clinical Commissioning Group
• Local Authorities including public health functions
• A person providing primary medical services (e.g. GPs)
• A person providing primary dental services (i.e. dentists)
• A person providing primary ophthalmic services (i.e. opticians)
• A person providing pharmaceutical services (e.g. community pharmacists)
• A person who owns or controls premises where ophthalmic and pharmaceutical services are provided
• Bodies or institutions which are contracted by Local Authorities or NHS Trusts, Clinical Commissioning Group to provide care services
• Service Providers contracted to provide health and social care services by the NHS or Local Authority.
• Service providers in receipt of funds from personal budget allocations
• NHS England commissioned services

• If the visit compromises either the effective provision of a service or the privacy or dignity of any person
• If the premises where the care is being provided is a person’s own home (this does not mean that an authorised representative cannot enter when invited by residents)
• Where the premises or parts of premises are used solely as accommodation for employees
• Where the premises are non-communal parts of care homes
• Where health and social care services are not provided at the premises (such as offices) or where they are not being provided at the time of the visit (for example when facilities and premises are closed)
• If, in the opinion of the provider of the service being visited, the authorised representative, in seeking to enter and view its premises, is not acting reasonably and proportionately
• if the authorised representative does not provide evidence that he or she is authorised
• To the observing of any activities which relate to the provision of social care services to people under the age of 18

An individual visit may inherit its purpose from a programme of which it is part, often refining this to be specific to ‘Enter and View’. However, a visit does not have to be part of a programme. It could, for example, be prompted by feedback from local service users, patients, their carers and families, which suggests common concerns about performance or aspects of provision on a single ward or care home.

A visit may be made to follow-up on points raised during a prior CQC inspection, to establish whether planned corrective actions are being taken. Healthwatch Bracknell Forest could be invited in by a provider to assess the impact of a change, or to observe and make suggestions with regard to a particular matter that is giving concern internally; a group of providers could ask for support in identifying and sharing ‘best practice’ in a specific area. 

This procedure describes the processes and arrangements for members of Healthwatch Bracknell Forest’s Enter and View Team to enter and view premises providing health and social care services.

In conjunction with the purpose of the visit and its aims; the group will observe and assess the nature and quality of services, obtain the views of people using those services, validate evidence already collected and gather information from both staff; services users and carers. 

Prior to a visit, Healthwatch Bracknell Forest will supply the provider of the service with the following information in writing:

1. Proposed date and time for the visit, along with an approximate duration
2. The information that has prompted the visit excluding the source of the information
3. The purpose of the visit
4. The overall structure of the visit:

• Identifying staff and service users that the authorised representatives would like to meetThe number and nature of any discussions along with the identification of any special communication or access needs
• The activities that the authorised representatives wish to observe
• Whether the authorised representatives will be distributing leaflets or other information about Healthwatch Bracknell Forest
• Whether or not it would be beneficial for staff or service users to accompany the authorised representatives throughout the visit
• The names of the authorised representatives conducting the visit
• The identification that Healthwatch Bracknell Forest authorised representatives will provide
• Re-assurance that the draft findings will be shared with the provider of the service prior to being finalised and distributed more widely
• Where appropriate, draft findings will also be shared with relevant parties whose information may have prompted the visit

Un-announced visits should not take place if any other approach could produce the information Healthwatch Bracknell Forest is seeking.  Un-announced visits must be in response to a concern highlighted by the community.

The rationale for undertaking such a visit must be documented by Healthwatch Bracknell Forest, along with the reason for not addressing the situation in another way.

Where Healthwatch Bracknell Forest decides it is necessary to conduct an unannounced visit, the information above will be provided upon arrival. 

Persons authorised to enter and view must:

• Gather any prior information such as past visit reports, or information from other groups involved with the service.  Healthwatch Bracknell Forest must have a clear view about the purpose of its visit, and be as informed as possible beforehand.
• Healthwatch Bracknell Forest may request reasonable information prior to the visit under the Freedom of Information Act, whilst remaining aware of the burden it may be placing upon the service to research and provide this data.  This could include such statistical information as staffing levels, missed appointments, opening times etc.
• Upon arrival, Enter and View representatives must make their presence known to the person they have arranged to meet, or to the most senior person on duty, and produce their written authorisation.
• Abide by any instruction given regarding privacy and dignity, health and safety and hygiene, and co-operate with requests from staff, service users and carers.
• Ensure during and before the visit that it is understood that Healthwatch Bracknell Forest cannot deal with individual complaints, but that Healthwatch Bracknell Forest representatives can and should signpost any such requests or disclosures to the appropriate body.
• Maintain confidentiality of verbal and written information, including the identification of individuals, access to records, adherence to protocols concerning disclosure by patients, service users and carers, and whistle blowing by staff, and care of notes concerning findings to be included in the report.
• Be aware of their obligations of disclosure regarding issues of child safety and vulnerable adults.
• Not to be alone in private with a patient or service user, but remain in communal areas and work in pairs if asked to speak in confidence.
• Avoid entering any non-communal areas such as bedrooms or staff quarters.
• Avoid commenting on personal equipment or belongings.
• Never give opinion or advice on specific care or treatment regimes to patients or service users, their relatives or carers.  Any such queries must be referred to the staff in charge.
• Work co-operatively with staff to maintain confidence in services, e.g. avoid criticism in front of service users, but include it in the de-brief to the provider of the service before leaving and in the written report.
• Adhere to protocols concerning gifts, gratuities and benefits.
• Be as unobtrusive as possible and avoid disrupting routines or service delivery.
• Value people as individuals, and respect their wishes, e.g. to leave someone alone if asked to do so.
• Do not behave in a discriminatory way.
• Inform the person they have arranged to meet, or to the most senior person on duty of their departure, and give verbal feedback as to the intended general content of the written report.
• Use a pro-forma or checklist to gather a comparable data set, plus any additional information pertinent to that visit.  Healthwatch Bracknell Forest may consider the evidence it wishes to gather in support of the annual health check when developing such checklists in order to build up a databank of evidence.
• Inform the Healthwatch Bracknell Forest Enter & View Lead Officer of any potential problems or conflict which may arise from the findings.
• Work together after the visit to de-brief and put together evidence based written feedback of their findings to the service visited.
• Provide written report to appropriate authority other than that service as required
• Provide a written report to the Healthwatch Bracknell Forest Management Board, the service provider and service users of the findings.  The report should be a balanced assessment of the service and may or may not contain recommendations.  Reports may also, depending upon the issues identified, be sent to the Health & Wellbeing Board, the Overview and Scrutiny Committee and the commissioner of that service.  

Treat all people fairly and courteously, with sensitivity and respect

• Treat people with dignity, and respect their privacy
• Be as unobtrusive as possible
• Inform people, especially staff, of what you are doing at each stage of the visit
• Value people as individuals, respecting difference and diversity
• Exhibit no discriminatory behaviour
• Have respect for individual confidentiality, not disclosing confidential or sensitive information unless there is a genuine concern about the safety and wellbeing of a service user, or if the person consents to the sharing of information
• Co-operate with requests from staff, service users, carers and their families
• Comply with all operational health and safety requirements, and with ‘house rules’
• Ensure that you do not interrupt the effective delivery of health and social care services
• Do not make unreasonable requests or demands
• Recognise that the needs of people using and receiving health and social care services take priority over the visit
• Be guided by staff where operational constraints may deem visiting activities inappropriate or mean that staff are unable to meet the requests of the visiting team
• Dress appropriately, including consideration for infection control, e.g. no ties
• Do not accept gifts or hospitality
• Introduce yourself to people and gain an individual’s agreement before talking to them
• Apply the Seven Principles of Public Life (the Nolan Principles):
  • Selflessness
  • Integrity
  • Objectivity
  • Accountability
  • Openness
  • Honesty
  • Leadership

Please refer to the print friendly version above for the detailed process model.