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Inspection carried out on 27 June 2019

During a routine inspection

This service is rated as Good overall

. (Previous inspection March 2018 was not rated)

The key questions are rated as:

Are services safe? – Requires improvement

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 Doctorcall London on 27 June 2019 as part of our inspection programme. The inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 so that an overall rating could be given.

Doctorcall London is part of Doctorcall Limited. Doctorcall London offers a 24-hour medical visiting service across London and primary care appointments at its clinic in Harley Street. These services treat children and adults. There are arrangements in place for secondary referral to diagnostic and specialist services as appropriate.

The service manager is the registered manager for the location. 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.

Ten patients attending the clinic had completed Care Quality Commission comment cards. All the comments received were positive with several patients stating that they received excellent care and support for issues that had not been treated well elsewhere. Reception staff and clinicians were consistently described as friendly and caring.

Our key findings were:

  • Systems were in place to protect people from avoidable harm and abuse.
  • However, the practice had not identified and addressed all risks, particularly its readiness for medical emergencies and the safe management of medicines and prescribing.
  • When mistakes occurred, lessons were learned and action was taken to minimise the potential for recurrence. Staff understood their responsibilities under the duty of candour.
  • Staff were aware of current evidence-based guidance.

  • Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
  • Patient feedback indicated that patients were very positive about the service.
  • The service was accessible to patients. The visiting doctors service was available 24 hours a day.
  • There was clear leadership, staff felt supported and the staff team worked well together.

  • There was a vision to provide a high quality, personalised service.
  • There was scope to increase the scope and impact of quality improvement activity.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way for service users

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review the quality improvement programme with a view to increasing the scope and impact of clinical audit and other improvement work.
  • Consider sharing individual-level clinical performance information with the individual clinicians concerned to encourage improvement.

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

Inspection carried out on 13 March 2018

During a routine inspection

We carried out an announced comprehensive inspection on 13 March 2018 to ask the service the following key questions: Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

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

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether The service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Doctorcall London offers a 24 hour visiting doctor service within London and primary care appointments with a doctor at its clinic with onward referral to diagnostic and specialist services as appropriate. These services treat children and adults.

The service has a designated 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.

Our key findings were:

  • Systems were in place to protect people from avoidable harm and abuse.
  • When mistakes occurred lessons were learned and action was taken to minimise the potential for reoccurrence. Staff understood their responsibilities under the duty of candour.
  • Staff were aware of current evidence based guidance.
  • Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
  • Patient feedback indicated that patients were very satisfied with the service.
  • Information about services and how to complain was available.
  • There was clear leadership and staff felt supported. The service team worked well together.
  • There was a clear vision to provide a high quality, personalised service.
  • The service had systems in place to monitor and improve the quality of service provision.

There were areas where the provider could make improvements and should:

  • Review arrangements to ensure that equipment and medicines held by doctors who are visiting patients are checked and calibrated as necessary.
  • Review its procedures to check the identity of children and accompanying adults attending the clinic.
  • Review its quality improvement programme and, for example, embed clinical audit more systematically in its monitoring of performance.

Inspection carried out on 27 August 2013

During a routine inspection

It was not possible to speak directly to people who used the service as there were no appointments booked during our inspection. However, we looked at 21 feedback questionnaires that had been completed in 2013. People felt that that the doctors had taken appropriate action to address their health complaint. One person described their doctor as “excellent” whilst another described the service as “very good”. There was a complaints policy in place, which was made available to people who used the service. There had been no complaints in the year preceding our inspection, but the provider kept a log of all complaints received and the action taken.

People were required to give written consent before they received any treatment. People received care that ensured their safety and welfare from staff who had been appropriately recruited. A medical history was taken and people were always treated by a doctor. There were arrangements in place to deal with medical emergencies and, where necessary, people were referred to an alternative service for treatment.

Inspection carried out on 1 February 2012

During a routine inspection

People who use the service made very positive comments about it and the treatment they received.

They told us they felt respected, treated with dignity, safe using the service and staff were competent, professional and courteous. They were informed of the consultaton process, fees and how screening, diagnosis and treatment would take place. This enabled them to be involved in decision-making about the choices of treatment available and included any risks attached.

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