The Care Quality Commission
  • Doctor
  • Out of hours GP service

Archived: Herschel Medical Centre Primary Care Centre

Overall: Good read more about inspection ratings

Herschel Medical Centre, 45 Osborne Street, Slough, Berkshire, SL1 1TT (0118) 936 5390

Provided and run by:
East Berkshire Primary Care Out Of Hours Services Limited

All Inspections

5 July 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at East Berkshire Primary Care Out of Hours Services Limited – Herschel Medical Centre Primary Care Centre on 4 October 2016 found a breach of regulations relating to the safe and well-led delivery of services. The overall rating for the service was requires improvement. Specifically, we found the service to require improvement for the provision of safe and well led services. The service was rated good for providing effective, caring and responsive services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for East Berkshire Primary Care Out of Hours Services Limited on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 5 July 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in October 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the service had made improvements since our last inspection. At our inspection on the 5 July 2017 we found the service was meeting the regulations that had previously been breached. We have amended the rating for the service to reflect these changes and improvements. East Berkshire Primary Care Out of Hours Services Limited – Herschel Medical Centre Primary Care Centre is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the service is now rated as good.

Our key findings were as follows:

  • East Berkshire Primary Care Out of Hours Services had comprehensively reviewed the existing governance framework in place and embedded the current models of best practice across all of the services locations.
  • The medicines management team had implemented new processes to ensure that the service actioned all patient safety alerts and MHRA (Medicines and Healthcare Products Regulatory Agency) alerts.
  • Prescription stationary was stored securely and tracked through the service at all times; this included when prescriptions were in the out of hours vehicles.
  • The service reviewed the Controlled Drug Home Office licence requirements and contacted the Home Office for confirmation and to begin the registration process.
  • There was now a designated person specifically to manage quality, ensure improvements were made and sustained. This included consideration of location specific clinical audits to review, monitor and improve outcomes for people accessing care and treatment at the different locations within the service. Furthermore, this included a review of all the feedback and areas of improvement that we reported on following the October 2016 inspections. For example, vehicle equipment checks were completed in line with the service policy and regular infection control checks completed on-site.
  • Arrangements to manage training had been strengthened. Specifically, we saw all staff undertaking chaperoning duties, including the drivers of out of hours vehicles, had received appropriate chaperone training. Furthermore, as part of the review of training arrangements a member of staff had been appointed to monitor all training arrangements within the service.
  • The service had reviewed and taken steps to improve signage across all five primary care centres to ensure patients visiting each site could access the services without delay.
  • Information for patients about the complaints procedure was clearly on display and carried in vehicles for patients receiving care and treatment in their place of residence.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

4 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at East Berkshire Primary Care Out of Hours Services Limited – Herschel Medical Centre Primary Care Centre on 4 October 2016. Overall the service is rated as requires improvement.

Specifically, we found the service to require improvement for the provision of safe and well led services. The service is rated good for providing effective, caring and responsive services.

Our key findings across all the areas we inspected were as follows:

  • There was an effective system for reporting and recording significant events. A wide range of events was reported. They were systematically assessed and dealt with.
  • Risks to patients were assessed and well managed. However, some systems to address these risks were not implemented well enough to ensure patients were kept safe. For example, the service had not always taken appropriate action in relation to recent alerts from the Medicines and Healthcare Products Regulatory Agency (MHRA). We found vehicle equipment checks were not completed in line with the service policy and regular infection control checks were not completed on-site. Unlogged prescriptions were found in the Out of Hours (OOH) vehicles.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • There were safeguarding systems in place for both children and adults at risk of harm or abuse as well as palliative care (care for the terminally ill and their families) patients who accessed the out of hours to the service.
  • Verbal and written patient feedback said they were treated with compassion, dignity and respect and despite that the service provided single episodes of care, patients were involved in their care and decisions about their treatment. Comment cards that patients completed confirmed this finding.
  • The premises were well equipped to treat patients and meet their needs, with the exception of some items of equipment, such as blood glucose testing strips and needles, which were out of date. The out of date equipment was found in the vehicle and the services’ on site stock.
  • There was limited information on display about how to complain and no complaint information was available in the mobile vehicles for patients receiving care and treatment in their place of residence. The complaints we reviewed were fully investigated by a senior member of staff and patients were responded to with an apology and full explanation.
  • Patients said they found it easy to make an appointment and data showed most patients were seen or contacted in a timely manner.
  • There was a clear leadership structure. Staff felt supported by the management team.
  • The service was aware of and complied with the requirements of the duty of candour.
  • The provider had a clear vision and strategy promoting positive outcomes for patients in Berkshire and Richmond.
  • The provider has been working with the local Clinical Commissioning Groups to discuss how to improve and maintain response times for patients accessing the service.

However, there were also areas of practice where the service needs to make improvements. The areas where the service must make improvements are:

  • Ensure the governance framework and processes are improved. Including a review of the systems and processes to ensure that the service actions patient safety alerts and MHRA (Medicines and Healthcare Products Regulatory Agency) alerts; undertaking site specific quality improvement activity and a review of the governance arrangements and operating procedures for the services use of Controlled Drugs, including an application for a Controlled Drugs Home Office license.
  • Ensure all equipment both in vehicles and on-site is within date and regularly tested in accordance with the manufacturing guidelines; infection control audits are completed regularly; and medical equipment checking identifies and removes items passed the expiry date.

The areas where the service should make improvements are:

  • Review signage ensuring the correct telephone number is displayed at Herschel Medical Centre Primary Care Centre.
  • Ensure that staff undertaking chaperoning duties have received the appropriate training, including the drivers of the OOH vehicles.
  • Information to patients about the complaints procedure should be on display and carried in vehicles to be made available to patients receiving care and treatment in their place of residence.
  • Ensure prescription stationary is stored securely at all times, specifically in the OOH vehicles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

7 March 2013

During a routine inspection

East Berkshire Primary Care Out Of Hours Service (EBPCOOH) provided out of hours general practitioner (GP) services to the Slough, Windsor & Maidenhead, South Bucks and Bracknell areas. The EBPCOOH web site provided clear explanations of the services offered and how they were accessed. There was a service guide, information about how to make a complaint or provide feedback and general health information.

We spoke with two people who used the service. They were positive about the service they received at Herschel Medical Centre, One person told us they had been given a timed appointment, the other person arrived at the centre without having first telephoned for an appointment. Nonetheless, they were seen by a GP within half an hour. The people we spoke with who had used the service told us they felt safe. They said the secure access arrangements to the medical centre provided confidence when using it at night.

We found there were effective staff recruitment and selection processes in place. People were cared for, or supported by, suitably qualified, skilled and experienced staff.

We found there were a number of quality monitoring processes in place. These included a range of reports, provided at different frequencies for stakeholders and commissioning bodies. This showed people who used the service were protected against inappropriate or unsafe care because standards were being monitored and appropriate actions were being taken when required.