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Archived: Salford Health Matters Homeless Service Good

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Salford Health Matters Homeless Service on 25 November 2015. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. For example the practice had close links with the Drug and Alcohol Team, Citizens Advice Bureau and Sexual Health Services.

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • The practice facilities were in need of improvement and this had been recognised by Salford Health Matters.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

  • The practice employed a link worker that assessed the health and social care needs of the patient. This enabled a care plan to be put in place that was tailored to the specific needs of the patient.

The areas where the provider must make improvements are:

  • Damage to the staircase leading up to the GP surgery was observed. While there have been no instances of an accident, there is potential for a trip to occur. Maintenance on this area should be carried out to ensure the staircase is safe for all people using it.

  • The current method of examining patients involved the blind on the surgery door being pulled down, and a member of staff standing outside of the surgery to prevent anyone from entering during examination. A curtain round the examination bed needs to be installed in order to maintain patient privacy.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 February 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When there are unintended or unexpected safety incidents, people receive reasonable support, truthful information, a verbal and written apology and are told about any actions to improve processes to prevent the same thing happening again.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed.

Effective

Good

Updated 11 February 2016

The practice is rated as good for providing effective services.

  • Data showed patient outcomes were at or above average for the locality.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of people’s needs.

Caring

Good

Updated 11 February 2016

The practice is rated as good for providing caring services.

  • Feedback from patients about their care and treatment was consistently and strongly positive.

  • We observed a strong patient-centred culture.

  • Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this.

  • We found many positive examples to demonstrate how patient’s choices and preferences were valued and acted on.

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

  • Information for patients about the services available was easy to understand and accessible.

We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

Responsive

Good

Updated 11 February 2016

The practice is rated as good for providing responsive services.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. The practice had strong links with the local drug and alcohol team enabling better support to patients with alcohol or drug addictions.

  • There are innovative approaches to providing integrated person-centred care.

  • Patients can access appointments and services in a way and at a time that suits them. The practice was able to offer appointments at a sister practice in certain circumstances.
  • Information about how to complain was available and easy to understand, and the practice responded quickly when issues were raised. Learning from complaints was shared with staff and other stakeholders.
  • It reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified. The practice was aware of the limitations of the current facility and had secured a new location to move to.

  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.

  • Information about how to complain was available and easy to understand and evidence showed that the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 11 February 2016

The practice is rated as good for being well-led.

  • Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice.

  • It had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to this.

  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.

  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

  • The provider was aware of and complied with the requirements of the Duty of Candour. The directors encouraged a culture of openness and honesty. The practice had systems in place for knowing about notifiable safety incidents

  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

  • There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions

Not sufficient evidence to rate

Updated 11 February 2016

Due to the low number of people with long-term conditions using the service, there was not enough evidence to make a judgement.

Families, children and young people

Not sufficient evidence to rate

Updated 11 February 2016

Due to the low number of Families, children and young people using the service, there was not enough evidence to make a judgement.

Older people

Not sufficient evidence to rate

Updated 11 February 2016

Due to the low number of older people using the service, there was not enough evidence to make a judgement.

Working age people (including those recently retired and students)

Good

Updated 11 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

  • The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

  • The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

  • It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

  • Staff had a good understanding of how to support people with mental health needs.

  • The practice had in place a screening tool to identify patients that could be suffering from anxiety or depression. The tool was used when registering new patients.

People whose circumstances may make them vulnerable

Outstanding

Updated 11 February 2016

The practice is rated as outstanding for the care of people who circumstances may make them vulnerable.

  • The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

  • It offered longer appointments for people with a learning disability.

  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

  • It had told vulnerable patients about how to access various support groups and voluntary organisations.

  • Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

  • Clothing would often be donated to patients whose clothing was no longer suitable to wear

  • Financial assistance could be offered to patients who needed to travel to hospital for an appointment but lacked the funds to access public transport

Extra support was offered to patients that were suffering harassment. Patients would be advised to speak to a member of staff who would help deal with the situation.