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Archived: FCMS Out of Hours Good

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 22 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Urgent Care Centre Blackpool on 14 March 2017. Overall the service is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
  • Risks to patients were assessed and well managed.
  • Patients’ care requirements were assessed and delivered in a timely way according to need.
  • The service met the National Quality Requirements.
  • Staff delivered care in line with current evidence based guidance.
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • There was a system in place that enabled staff access to patient records, and the out-of-hours staff provided other services, for example the patient’s own GP and hospital, with information following contact with patients as was appropriate.
  • The service managed patients’ care and treatment in a timely way.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
  • The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
  • 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 and complied with the requirements of the duty of candour.

We identified the following areas of outstanding practice:

  • The organisation had implemented an End of Life care pathway in conjunction with the Hospice at Home Team. There was a direct referral route for all patients across the Fylde Coast requiring access to the Hospice at Home provision. The service was a tri-partnership between the hospice, FCMS and two local CCGs (Clinical Commissioning Groups) that delivered a unique approach to unscheduled care overnight, reacting to prevent avoidable admissions at the end of life.
  • The organisation worked with the ambulance service to reduce hospital admissions and had made some significant changes to how work is distributed around the local healthcare economy. For example in one week 203 ambulance cases were assessed and 186 (91%) were deflected to more appropriate services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 22 June 2017

The service is rated as good for providing safe services.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • There was an effective system in place for recording, reporting and learning from significant events
  • Lessons were shared to make sure action was taken to improve safety in the service.
  • When things went wrong patients were informed in keeping with the Duty of Candour. They were given an explanation based on facts, an apology if appropriate and, wherever possible, a summary of learning from the event in the preferred method of communication by the patient. They were told about any actions to improve processes to prevent the same thing happening again.
  • The out-of-hours service had clearly defined and embedded system and processes in place to keep patients safe and safeguarded from abuse. Staff 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.
  • When patients could not be contacted at the time of their home visit or if they did not attend for their appointment, there were processes in place to follow up patients who were potentially vulnerable.
  • There were systems in place to support staff undertaking home visits.

Effective

Good

Updated 22 June 2017

The service is rated asgood for providing effective services.

  • The service was consistently meeting National Quality Requirements (performance standards) for GP out-of-hours services to ensure patient needs were met in a timely way.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Clinicians provided urgent care to walk-in patients based on current evidence based guidance.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.
  • The organisation had implemented an End of Life care pathway in conjunction with the Hospice at Home Team. There was a direct referral route for all patients across the Fylde Coast requiring access to the Hospice at Home provision. The service was a tri-partnership between the hospice, FCMS and two local CCGs (Clinical Commissioning Groups) that delivered a unique approach to unscheduled care overnight, reacting to prevent avoidable admissions at the end of life.
  • The organisation worked with the ambulance service to reduce hospital admissions and had made some significant changes to how work is distributed around the local healthcare economy. For example in one week 203 ambulance cases were assessed and 186 (91%) were deflected to more appropriate services.

Caring

Good

Updated 22 June 2017

The service is rated as good for providing caring services.

  • Feedback from the large majority of patients through our comment cards and collected by the provider was very positive.
  • 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 easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • Patients were kept informed with regard to their care and treatment throughout their visit to the out-of-hours service.

Responsive

Good

Updated 22 June 2017

The service is rated as good for providing responsive services.

  • Service staff reviewed the needs of its local population and engaged with its commissioners to secure improvements to services where these were identified.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • The service had systems in place to ensure patients received care and treatment in a timely way and according to the urgency of need.
  • Information about how to complain was available and easy to understand and evidence showed the service responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 22 June 2017

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

  • The service 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 service had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the duty of candour. The provider encouraged a culture of openness and honesty. The service had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken
  • The service proactively sought feedback from staff and patients, which it acted on.
  • There was a strong focus on continuous learning and improvement at all levels.