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Archived: 7 Day Healthcare Inadequate

Reports


Inspection carried out on 12 June 2019

During a routine inspection

This service is rated as Inadequate overall. (Previous inspection – January 2018)

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection of the private doctor service at 7 Day Healthcare on 12 June 2019 as part of our inspection programme, and to follow up on breaches of regulations.

CQC inspected the service in January 2018 and asked the provider to make improvements to ensure care and treatment is provided in a safe way to patients, and to establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. We checked these areas as part of this comprehensive inspection and found they had been partly resolved.

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. At 7 Day Healthcare, private doctor and dental services are provided which are within the scope of CQC regulation.

There are some 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 7 Day Healthcare, intense pulse light (IPL) treatments are provided for hair removal, and there is a foot care service. These services are not within the remit of this Act and CQC regulation.

The nominated individual is the 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.

17 people provided feedback about the service; 16 people completed comment cards and we spoke with one person using the service.

Our key findings were:

  • The service received positive feedback about patients’ care and treatment experiences. The service treated patients with care and compassion and involved them in decisions about their care.
  • The service delivered services to meet patients’ needs that took account of their preferences, and they listened to and responded to concerns and complaints.
  • The service was not providing safe services as they had poor safety systems and processes, poor management of patient safety risks and a lack of reliable systems for appropriate and safe handling of medicines.
  • The provider had made improvements since our last inspection in the provision of effective care as they had better arrangements to ensure training and peer support for their staff team and had started carrying out quality improvement activities in relation to clinical care. However, they did not consistently work effectively with other organisations to deliver services.
  • The provider has partly made improvements in the arrangements to support good governance and management. But there were inconsistencies in the processes for managing risks.

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 to patients
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

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

The areas where the provider should make improvements are:

  • Review their arrangements to protect patients’ privacy and dignity in the minor surgery operations room.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 30 and 31 January 2018

During a routine inspection

We carried out an announced comprehensive inspection to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led? We carried out site visits on 30 January 2018 to review the private doctor service and on 31 January 2018 to review the dental service.

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not 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 not 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

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. At 7 Day Healthcare, private doctor and dental services are provided which are within the scope of CQC regulation.

There are some 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 7 Day Healthcare, intense pulse light (IPL) treatments are provided for hair removal, and there is a foot care service. These services are not within the remit of this Act and CQC regulation.

Mr Surrinder Gulsin is the 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.

Fourteen patients provided feedback about the GP service through completed comments cards, and 10 patients provided feedback about the dental service in the practice. We spoke with two patients, both of whom had received treatments in the dental service, during our inspection.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.

The practice asked staff and patients for feedback

We identified regulations that were not being met and the provider must:

  • Ensure care and treatment is provided in a safe way to patients

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider should make improvements:

  • Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

  • Review arrangements for checking parental responsibility of the accompanying adult when children received vaccinations.

Inspection carried out on 9 October 2013

During a routine inspection

Only one person using the service was available to discuss their consultation or treatment. One person we spoke with told us that they were satisfied with the level and quality of services being provided by the doctor and reception staff. They told us that the doctor listened to them and talked through the various treatment options and it was a �fantastic service�. We saw feedback correspondence from people, one person stated that �it is the best dental care we have had� and �if I had an emergency I know I would be seen immediately by one of your dentists�.

We found that people had given their consent before they had received any care or treatment. People's health care needs were assessed, treatment plans developed and delivered in line with their individual care plan. People were cared for in a clean, hygienic environment. The provider had completed all appropriate checks for majority of the staff before they began work. There was evidence that quality monitoring audits had taken place on a regular basis, and that learning from the audits was taking place and necessary changes had been implemented.

Inspection carried out on 31 January 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, this included talking to staff and reviewing peoples feedback and correspondence about the service.This was because the people using the service were not available to discuss their consultation or treatment . We saw correspondence that stated 'this was the best dental care we have ever had' and ' it was pleasant and friendly for people who are nervous'.

Staff were observed to be welcoming but took care to ensure people's privacy and dignity were respected. People were provided with information about fees before using the service. Peoples needs were discussed and risk assessed with them prior to their treatment to ensure their care was delivered safely and meet their individual requirements. People given time to consider whether to have treatment and appropriate information to allow them to make an informed decision.

The premises were clean,warm and well equipped to provide the services offered to people. Appropriate standards of cleanliness and hygiene were maintained to safely provide dental and cosmetic treatments and procedures to people and minimise their risk of infection.

Records of peoples care were well documented and securely stored. The quality and safety of the service was continuously monitored by the provider through the use of audits and people's feedback . Staff were qualified and trained to provide care and treatment to people using the service.

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