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Archived: Claremont Hospital

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Inspection report

Date of Inspection: 15 February 2011
Date of Publication: 4 March 2011
Inspection Report published 4 March 2011 PDF

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People's personal records, including medical records, should be accurate and kept safe and confidential (outcome 21)

Meeting this standard

We checked that people who use this service

  • Their personal records including medical records are accurate, fit for purpose, held securely and remain confidential.
  • Other records required to be kept to protect their safety and well being are maintained and held securely where required.

How this check was done

Our judgement

We found that processes are in place to ensure personal records are accurate, held securely and kept confidential. No gaps in assurance or areas of concern were identified during the assessment of this outcome for this location.

User experience

It was not possible to gain the direct views of people who use the service for this outcome.

Other evidence

The provider declared compliance with this outcome at this location at registration with CQC October 2010.

As part of the assessment of this location the provider submitted a 'provider compliance assessment' record for this outcome. The hospital set out information, which explained how this outcome was being met, with references to supporting evidence. For example the hospital has a range of procedures in place regarding the management of personal and medical records and it was reported that the hospital holds an active ISO 27001 certification (Information security management standards).

The hospital also voluntarily provided additional supporting evidence to demonstrate compliance with this outcome, which were largely the current policies and procedures relevant to this outcome.

On the site visit we sampled a small number of patient records. Those reviewed demonstrated a reasonable standard of record keeping. No patient records audit had been completed in the last 12 months though a new process is being rolled out to departments (see outcome 16).