This service is rated as Good overall.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out this announced comprehensive inspection on 27 November 2018. We had previously carried out an announced comprehensive inspection on 26 September 2017. At that time the service was rated as requires improvement. It was rated as requires improvement for the safe, effective and well led domains and good for caring and responsive.
The areas where we said that the provider must make improvement were:
- Develop effective systems and processes to ensure safe care and treatment including, the storage and dispensing of medicines and ensuring that non-calibrated equipment is not stored where it might be used. The service should ensure that targets relating to the time taken to stream patients are met.
- Develop effective systems and processes to ensure good governance including ensuring streaming services are clear and understood by all staff. They should also ensure patient group directives are in place for nursing staff. The service should review that performance data meets national guidelines.
Since the last inspection the service no longer provided urgent care services, and was out of hours only.
At this inspection we found:
- The service had good systems to manage risk so that safety incidents were less likely to happen. The provider had taken steps to assure itself that incidents were not missed.
- The service routinely reviewed the effectiveness and appropriateness of the care it provided.
- The service was below target levels for National Quality Reporting (NQR) standards in some areas, but not by a significant margin, and performance was improving since the last inspection.
- Audits were in place to monitor the performance of staff at the service.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- The service had a clear system for managing and learning from complaints.
- The service had an overarching governance framework in place, including policies and protocols which had been developed in conjunction with its partner organisations.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- The service proactively sought feedback from patients to evaluate the quality of the service being provided.
The areas where the provider should make improvements are:
- Review which audits are undertaken to ensure that high risk, high cost and high dependency medicines are used in line with guidelines.
- Continue to review NQR standards to ensure that they are met.Inform all doctors that they should use only equipment provided by the service.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice