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Archived: Hollow Way Medical Centre

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Inspection Summary


Overall summary & rating

Updated 10 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hollow Way Medical Centre (OxFed) on 8 March 2017. Due to the nature of the service inspected we did not apply ratings. OxFed Health and Care Limited (OxFed) is a health federation that works with the 21 GP practices in Oxford City. The Hollow Way Medical Centre site is used by the federation as their administrative headquarters. Clinical services are not provided by the federation at this location. At the time of inspection OxFed was providing two services. These were:

  • A team of seven care navigators that work with patients in their own home. Following inspection we found this service did not undertake any regulated activities and is out of scope of CQC registration. Therefore it is not included within this report.
  • A college nursing service delivered by two nurses employed by OxFed offering nursing support to students at colleges of the Oxford University. Clinical oversight and supervision is also given to 16 more nurses employed by various university college sites.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The provider had clearly defined and embedded systems to minimise risks to patient safety.

  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Information about services and how to complain was available.
  • The college nursing service operated from appropriate facilities and staff were equipped to treat patients and meet their needs.
  • Information was shared with the patient’s GP and other agencies when relevant to the care of the patient and where consent was taken.
  • There was a clear leadership structure and staff felt supported by management. The provider proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

  • Prioritise the development of quality improvement monitoring of the services provided.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Updated 10 May 2017

The provider was able to demonstrate:

  • From the sample of documented examples we reviewed, we found there was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety across the service. When things went wrong patients were informed as soon as practicable and received reasonable support. They were told about any actions to improve processes to prevent the same thing happening again.
  • The provider had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
  • Staff demonstrated that they understood their responsibilities and all had received training on safeguarding vulnerable adults relevant to their role.
  • The provider had adequate arrangements to respond to emergencies and major incidents.
  • Appropriate checks of college medical facilities had been undertaken to ensure they were safe environments in which to consult with students.
  • The provider had appropriate policies and procedures for lone workers and staff carried out their duties in accordance with these policies.

Effective

Updated 10 May 2017

The provider was able to demonstrate:

  • Staff were aware of voluntary and statutory services available to patients and there was evidence of appropriate referral and follow up.
  • Staff had the skills and knowledge to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.
  • Information was shared securely and promptly with the patient’s registered GP.

Caring

Updated 10 May 2017

The provider was able to demonstrate:

  • Information from college welfare departments and student unions showed that patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Updated 10 May 2017

The provider was able to demonstrate:

  • Patients we spoke with said nurses were prompt to respond to their needs and to urgent requests for advice and support.
  • The provider had ensured college medical rooms had good facilities and were well equipped to treat student patients and meet their needs.
  • Information about how to complain was available.
  • Information on how to access services was available in easy to understand formats and could be accessed via the provider website as well as from colleges and the patient’s registered GP.

Well-led

Updated 10 May 2017

The provider was able to demonstrate:

  • The provider had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff felt supported by management. The provider had policies and procedures to govern activity and held regular governance meetings.
  • An overarching governance framework supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • Staff had received inductions, annual performance reviews and attended staff meetings and training opportunities.
  • The provider encouraged a culture of openness and honesty. The provider had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.
  • The provider proactively sought feedback from staff and we saw examples where feedback had been acted on.
  • There was a focus on continuous learning and improvement at all levels. Staff training was a priority and was built into staff rotas.
Checks on specific services

People with long term conditions

Updated 10 May 2017

The provider was able to demonstrate.

  • College nursing staff were appropriately trained to support patients diagnosed with long term diseases. For example, in management of asthma.
  • Staff were aware of support groups in the area that supported patients with long term conditions.
  • If a student patient with a long term condition required additional medical support with their condition they were referred back to their registered GP in a timely manner.

Working age people (including those recently retired and students)

Updated 10 May 2017

The provider was able to demonstrate:

  • The needs of the student population had been identified and the provider had responded by offering services that met their needs. For example, drop in clinics that were appropriately promoted.
  • The provider made health promotion material and advice leaflets available in electronic formats which students could access at any time. Similar electronic access to health promotion material was available via the university websites and in hard copy format from college medical rooms.

  • Staff were aware that many student patients were living away from their families for the first time. They made time to listen to these patients by offering open ended consultations giving students time to talk through their concerns.

People experiencing poor mental health (including people with dementia)

Updated 10 May 2017

The provider was able to demonstrate:

  • They held information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations. Staff were able to refer to student counselling services.

  • Staff were aware of local support groups outside of the colleges to which students could be directed when appropriate

People whose circumstances may make them vulnerable

Updated 10 May 2017

The provider was able to demonstrate:

  • The college nurses worked with other health care professionals in the case management of vulnerable patients.
  • Staff had information available for vulnerable patients about how to access various support groups and voluntary organisations.
  • Nurses worked with GP practices when new students entered college at the start of autumn term. Additional clinics were held to ensure students were up to date with immunisations and identify any students with long term medical conditions.
  • Staff we spoke with knew how to recognise signs of abuse in adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.