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Blossoms Healthcare LLP - Garlick Hill Good

Reports


Inspection carried out on 27 June 2019

During a routine inspection

This service is rated as Good overall. The service was previously inspected in February 2018 and found to be meeting requirements for all domains.

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 an announced comprehensive inspection at Blossoms Healthcare – Garlick Hill on 27 June 2019 as part of our inspection programme.

The provider supplies private general practitioner services predominantly to staff employed by corporate clients. The provider also provides services to private fee-paying patients.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Blossoms Healthcare Garlick Hill, approximately 90% of patients are treated under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, we were only able to rate the services which are not arranged for patients by their employers. However, some of the evidence quoted in the report regarding the quality of fee-paying patient outside of this exemption stems from evidence of care provided to exempt patients as this was used to demonstrate the general quality of care provided to all patients using the service.

The provider is in the process of registering a new registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 12 CQC comments cards. All comment cards were positive with patients referring to the high standard of care provided by knowledgeable and supportive staff.

Our key findings were:

  • The provider had systems in place to keep people safe and to review, act and learn from significant events. We reviewed examples where the provider had made contact with the patient’s NHS GP to pass on information that was clinically necessary with the patient’s consent. We were told that, when necessary to ensure patient safety, the service would contact the patients NHS GP without consent.
  • There were processes in place to effectively handle emergencies and risks were managed appropriately. Recruitment checks had been completed for the staff whose files we reviewed.
  • Systems were in place for the safe management of medicines and we saw the provider had processes in place to review prescribing. Following a recent inspection at another of it’s registered locations, the provider had developed plans to undertake regular reviews of antibiotic prescribing.
  • Staff at the service assessed patients in accordance with best practice and current guidelines and had systems in place to monitor and improve the quality of care provided to patients.
  • There was evidence of effective joint working and sufficient staffing to meet the needs of their patient population.
  • Feedback indicated patients were treated with dignity and care and the service had systems to support patients to be involved with decisions about their care and treatment.

  • The service met the needs of their targeted patient demographic and there were systems in place for acting on feedback and complaints.
  • The service had adequate leadership and governance in place.
  • There was clear strategy and vision which was tailored to patient need and staff and patients were able to engage and feedback to the service provider.

The areas where the provider should make improvements are:

  • Follow through with plans to review antibiotic prescribing to assess the extent to which the service is following best practice and guidance.
  • Continue to review and assess emergency medicines kept on the premises to ensure decisions are justified and reflect the treatments provided and the patient groups who use the service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 14 February 2018

During a routine inspection

We carried out an announced comprehensive inspection on 14 February 2018 to ask the provider the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that the location was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that the location was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that the location was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that the location was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that the location was providing well-led care in accordance with the relevant regulations.

We carried out an announced comprehensive inspection of Blossoms Healthcare, Garlick Hill on 14 February 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions, to confirm that legal requirements and regulations associated with the Health and Social Care Act 2008 were being met. We had previously inspected the location in March 2013, using our old methodology, when we found it was compliant with the regulations applicable at the time. The provider also operates at two other locations in Central London, which we inspected on 20 February 2018.

Before the inspection we reviewed notifications received from and about the service and location, and a standard information questionnaire completed by the provider. During our visit we spoke with the location’s registered manager and doctors, the senior nurse, the location practice manager and administrative staff. We also met some of the provider’s corporate management team. We observed practice and reviewed documents.

Our key findings were:

  • The provider had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the provider learned from them and improved.
  • The provider reviewed the effectiveness and appropriateness of the care. It ensured that care and treatment was delivered according to evidence-based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Services were provided to meet the needs of patients.
  • Patient feedback was consistently positive.
  • There were clear responsibilities, roles and systems of accountability to support good governance and management.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 15 March 2013

During a routine inspection

We spoke with two people who had recently used the service. These two people said they were listened to and treated with respect. Both people who used the service told us they were happy with the service provided and would continue to regularly use the service. The clinic’s most recent patient survey results were also positive.

The staff were trained in basic life support and knew what to do in the event of a medical emergency. The environment was clean and well organised and we saw that people's privacy was protected. People using the service said the premises were clean and well equipped.

The provider had arrangements in place to make sure people were cared for safely and appropriate checks were carried out before new staff started.

We saw evidence that the quality of the service was effectively monitored and the provider sought feedback from patients.

Inspection carried out on 28 March 2011

During a routine inspection

During the visit we did not have the opportunity to speak to any patients directly. However observation of the practices of the medical centre, discussion with staff and inspection of records indicated that staff protected people’s privacy and dignity and generally treated them with respect. Most felt that staff listened to them and offered them choices about their care and treatment as far as possible.

The premises are well maintained and kept clean and hygienic, and there is a high standard of quality assurance systems in place, with appropriate complaints procedures used effectively. However there is room for improvement in safeguarding adults training, recording medicines received at the centre, addressing issues highlighted in the most recent fire risk assessment, and systems to check on references and qualifications of new staff, and their induction training and supervision.

Reports under our old system of regulation (including those from before CQC was created)