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Inspection Summary


Overall summary & rating

Updated 27 March 2018

We carried out an announced comprehensive inspection on 19 December 2017 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.

GPDQ Limited provides mobile, private GP services in the Greater London area and in Birmingham, through its location, GPDQ Service Office, also known as GPDQ. The organisation is based at Suite 18 St Marks Studios, 14 Chillingworth Street, London, N7 8QJ. The premises are used for management and administrative purposes only. The provider does not consult with patients in it its own premises.

The service is managed by a Management Board which includes a non-clinical Chairperson and Chief Executive Officer, a Chief Medical Officer and two Clinical Directors all of whom are qualified GPs. The Chief Medical Officer is also a partner in an NHS GP service. The Management Board is advised on clinical matters by a Clinical Board, two members of which are external advisors.

The Chief Medical Officer 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.

Our key findings were:

  • Staff were aware of current evidence based guidance and carried out clinical quality improvement activity to improve patient outcomes.
  • There was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the service.
  • Staff had been trained with the skills and knowledge to deliver effective care and treatment.
  • There were procedures for assessing, monitoring and managing risks to patient and staff safety.
  • There were effective protocols for verifying the identity of patients requesting GP consultations, including a step to ensure adults accompanying or requesting consultations for, paediatric patients had legal authority for the patient.
  • The service had processes to ensure clinicians who worked more often in NHS services, were knowledgeable about and had the resources to deliver safe and effective treatment as mobile doctors, for instance, by understanding how referrals could be made in different geographical areas.
  • Patients could access appointments and services in a way and at a time that suited them. Appointments could be booked over the telephone between 8am and 11pm every day, or at any time using the provider’s website and mobile application.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the service complied with these requirements.

Inspection areas

Safe

Updated 27 March 2018

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

  • The service had clearly defined processes and well embedded systems in place to keep patients safe and safeguarded from abuse.
  • The information needed to plan and deliver care and treatment was available to staff in a timely and accessible way.
  • The provider operated safe and effective recruitment procedures to ensure staff were suitable for their role.
  • Arrangements were in place for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs.
  • The provider had systems in place to support compliance with the requirements of the duty of candour. The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.
  • There was evidence of shared learning across the organisation and through dissemination of safety alerts and guidelines.

Effective

Updated 27 March 2018

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

  • Conversations with staff and supporting evidence provided as part of our inspection demonstrated that the continuing development of staff skills, competence and knowledge was recognised as being integral to ensuring that high quality care was delivered by the service.
  • The service carried out assessments and treatment in line with relevant and current evidence based guidance and standards.
  • There was a program of quality improvement and audits used to drive service improvement.
  • We saw evidence to demonstrate the service operated a safe, effective and timely referral process. Onward referrals resulted in a letter back to the doctor; we also saw patient consent was sought in line with legislation and guidance as part of this process.
  • The process for seeking consent was monitored through patient records audits and we saw evidence of this during our inspection. Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.

Caring

Updated 27 March 2018

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

  • Positive feedback was received from patients through the providers in-house patient satisfaction survey. Patients said they were treated with dignity and respect and were involved in decisions about their care and treatment.

  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

  • Staff respected and promoted patients’ privacy and dignity.

Responsive

Updated 27 March 2018

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

  • Patients could access appointments and services in a way and at a time that suited them. Appointments could be booked over the telephone between 8am and 11pm every day, or at any time using the provider’s website and mobile application.
  • Appointments were available between 8am and 11pm every day of the year, including all public holidays. We were told that the on average, appointments were available within 90 minutes of the patient accessing the service.
  • The service had arrangements in place to have on-call support from a clinical psychiatrist and had developed close links with specialist crisis care specialists so that patients with acute needs could be directed to appropriate support in a timely manner.
  • Patients could request a visit by male or female clinicians and could request to see the same doctor for repeat visits which meant that patients were able to experience continuity of care when this was important.
  • The service had a complaints policy in place and information about how to make a complaint was available for patients. We saw that complaints were appropriately investigated and responded to in a timely manner.

Well-led

Updated 27 March 2018

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

  • The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care. Staff we spoke with felt well supported and appropriately trained and experienced to meet their responsibilities.
  • There were consistently high levels of constructive staff engagement and there were high levels of staff satisfaction. During our inspection staff expressed pride in working for the organisation.
  • Governance arrangements were actively reviewed and reflected best practice. Systems were in place to ensure that all patient information was stored and kept confidential.
  • There were clear staffing structures in place; these reflected both board and local level staffing structures.
  • Staff we spoke with during our inspection were aware of their responsibilities as well as the responsibilities of their colleagues and managers.
  • There was a focus on continuous learning and improvement at all levels within the service. Staff were encouraged to identify opportunities to improve the service delivered through meetings, day to day review and the appraisal process.