24 March 2014
During a routine inspection
This inspection was carried out at the General Hospital in Clacton, Essex. This site is one of three from which Harmoni provide out-of-hours services for North East Essex, the others being Colchester District General Hospital and Fryatt Hospital in Harwich, Suffolk.
During the week the North East Essex Out of Hours starts to take telephone calls from patients and the 111 service at 18:30hrs. We were concerned that the duty GP did not commence their shift at the base until 19:30hrs. We have asked the provider to make sure that the arrangements they have in place for treating patients between 18:30 and 19:30 have been risk assessed, are robust and appropriate so the any risk to patient safety and well being is minimised and managed. Following the inspection the provider submitted a risk assessment that demonstrated that any foreseeable risk to patients who required treatment between 18:30 and 19:30 was being monitored and managed appropriately. This risk assessment was also submitted and shared by the provider with the North East Essex clinical commissioning group.
Patients told us that they were happy with the care they received and that they were involved in the decisions about their care. We were told that staff were polite and respectful and we observed this to be the case. During the inspection we looked at the treatment records of patients who used the service. We saw there was a system to ensure that patient information was promptly shared with each patient’s own GP to ensure continuity of care.
Staff had access to the appropriate equipment, training and support. The provider carried out the appropriate employment checks on new and temporary staff to ensure that they were able and safe to carry out their roles. Staff told us that they felt supported and that the service was well led. There were regular team meetings to ensure that information was cascaded to all staff team members; this included learning from incidents and changes to practice.
We carried out the inspection as part of our new inspection programme to test our approach going forward. It took place over two days with a team that included a CQC inspector, a CQC bank inspector, a registered nurse, a GP and an expert-by-experience.