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Archived: Hampshire Doctors On Call Good

The provider of this service changed - see old profile

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 16 March 2017

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Hampshire Doctors On Call to check that action had been taken since our previous inspection in November 2015. Overall the practice is rated as good.

At our previous inspection, the service was rated good for Effective, Caring, Responsive and Well Led services and was rated as good overall. However, the practice was rated as requires improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services.

This was because:

  • Non-clinical staff who acted as a chaperone had not received appropriate training and the policy did not reflect the role and purpose. Staff members acting as a chaperone did not have a risk assessment or a criminal records check via the disclosure and barring service (DBS). Where the decision had been made not to carry out a DBS check on staff, the service was unable to give a clear rationale as to why the check had not been carried out.

  • Relevant staff had not received all mandatory training including safeguarding children and basic life support.

We inspected the service on 29 and 30 September 2016 to confirm that they now met legal requirements.

You can read the last published report from our last comprehensive inspection of Hampshire Doctors on Call on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

  • The provider had been working with the five local clinical commissioning groups to discuss how to improve and maintain response times for patients accessing the service.
  • There was an open, transparent approach and a system in place for reporting and recording significant events.
  • The provider had introduced a programme of mandatory training modules for members of staff and was working through the programme. We saw that emails had been sent out from management to members of staff reminding them to complete the modules and a matrix was provided showing that 90% of the courses had been completed at the time of our inspection.
  • Relevant staff had received chaperone training and the provider carried out Disclosure and Barring Service checks for employees who may be asked to carry out the role of a chaperone. The chaperone policy had been reviewed and subsequently staff were issued with an aide memoir of the role. The provider had a continuing training programme for staff to become chaperones if they wanted to be. We saw patient information was available in the treatment sites we visited about chaperoning services.
  • Disclosure and Barring Service checks for employees were now being carried out.
  • The service had clearly defined processes and practices in place to keep people safe and safeguarded from abuse.
  • The service was introducing a new staff appraisals policy and process however they were unable to produce evidence that appraisals were regularly taking place. The service had taken over the responsibility for the delivery of the contract in April 2015. This included more than140 self-employed GPs working in 10 sites and more than100 employees from the previous service provider transferring. Staff we spoke with told us that they had received an appraisal when working for the previous employer in 2015. We were told the staff appraisals were due to commence in late 2016.

The practice is now rated good for Safe services.

However there were areas where the service should be improved.

  • The provider should improve on the delivery of plans for all staff employed to have an appraisal annually that is recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 16 March 2017

The service is rated as good for providing safe services.

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Information about safety was recorded, monitored, appropriately reviewed and addressed. Risk management was comprehensive, well embedded and recognised as the responsibility of all staff.
  • The premises and equipment at the locations inspected on this occasion were clean, hygienic and well maintained.
  • The service had arrangements in place to respond to emergencies and other unforeseen situations such as the loss of utilities.
  • Staff files for members of staff recruited since April 2015 were complete with appropriate recruitment checks undertaken prior to employment.
  • The service had clearly defined processes and practices in place to keep people safe and safeguarded from abuse.
  • Patients that we talked with told us that they felt safe.
  • Relevant staff had received chaperone training and the provider carried out Disclosure and Barring Service checks for employees who may be asked to carry out the role of a chaperone.
  • Disclosure and Barring Service checks for employees were now being carried out.

Effective

Good

Updated 16 March 2017

  • The provider had introduced a programme of mandatory training modules for members of staff and was working through the programme.
  • Emails had been sent out from management to members of staff reminding them to complete the modules.
  • A matrix was provided showing that 90% of the courses had been completed at the time of our inspection.
  • The service was introducing a new staff appraisals policy and process however they were unable to produce evidence that appraisals had regularly taken place. The service had taken over the responsibility for the delivery of the contract in April 2015. This included more than 100 employees from the previous service provider transferring. Staff we spoke with told us that they had received an appraisal when working for the previous employer in 2015. We were told the appraisal were due to commence in late 2016.

Caring

Good

Updated 4 February 2016

The service is rated as good for providing caring services.

  • Feedback from patients about their care and treatment was consistently and strongly positive. Patients, their relatives and carers were all positive about their experience and said they found the staff friendly, caring and responded to their needs.

  • We observed and heard a kind compassionate culture.

  • There was good evidence that the provider took positive steps to promote the service and informed patients of what they could expect from the service. There was health promotion literature available in the waiting room at both locations we inspected.

  • Patient experience surveys conducted by the provider and collected for the National Quality Ratings indicated a high degree of satisfaction with the service provided and a high number of patients who had used the service would recommend it.

Responsive

Good

Updated 4 February 2016

The practice is rated as good for providing responsive services.

  • We found that the provider had an effective system to ensure that, where needed, GP’s could provide a consultation in patients’ homes.

  • The provider had responded to the needs of people from a wide geographical area and provided a choice of 10 treatment centres across Hampshire for patients to maximise accessibility.

  • The provider undertook continuing engagement with patients to gather feedback on the quality of the service provided.

  • There was good collaborative working between the provider and other healthcare and social care agencies to help ensure patients received the best outcomes in the shortest possible time. For example, health care professionals (e.g. paramedics) could request a GP to commence a definite clinical assessment over the telephone within 15 minutes of placing the call. This reducesavoidable unplanned admissions by improving services for vulnerable patients and those with complex physical or mental health needs.

  • Information about how to complain was available and easy to understand and evidence showed that the service responded quickly to issues raised.

Well-led

Good

Updated 4 February 2016

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

  • There was a clear vision and strategy to deliver high quality care and promote good outcomes for patients.

  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included a comprehensive improvement and development action plan and arrangements to monitor and improve quality, performance whilst identifying risk.

  • The senior team encouraged a culture of openness and honesty.

    The provider was aware of and complied with the requirements of the Duty of Candour.

  • The service had systems in place for knowing about notifiable safety incidents.

  • There was a clear commitment to learn from problems, complaints and incidents. The provider demonstrated an open approach to these issues and informed staff of any learning through periodic newsletters, both clinical and general.

  • Feedback from staff and patients was sought and acted on. We saw active staff forums, newsletters and other forms of staff communication. Staff told us they were involved in decisions, for example, the possible relocation of the main headquarters and more recently testing possible vehicles to join the services fleet of cars.

  • Staff had received inductions; staff who transferred into the service received a welcome pack and we saw provisional appraisal dates and saw that staff attended meetings and events.