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Inspection Summary


Overall summary & rating

Updated 16 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced focussed inspection at HR Healthcare on 17 July 2017. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for HR Healthcare on our website at www.cqc.org.uk. This inspection was an announced focused inspection carried out on 17 July 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 22 November 2016 which led to the suspension of the service. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

  • There was now an effective system in place for recording and reporting significant events.
  • A system was in place to receive and act upon patient safety and medicine alerts.
  • The clinical system had been updated so clinical staff could now easily access patient records from previous consultations.
  • There was now a clear leadership structure in place.
  • There was now a system in place for quality improvement and clinical audit.
  • There was now an effective system in place to deal with emergency situations.
  • Staff were aware of safeguarding procedures and a policy was in place.
  • Information about making complaints was now clearly stated on the provider’s website.
  • Policies and procedures were now easily accessible to staff on the intranet.
  • The business continuity plan had now been updated to include relocation details.
  • There was now a policy in place to cover data security, protection, destruction and disposing of sensitive data.

We previously suspended the service on 2 December 2016 for three months initially. The suspension was then extended for a further three months as the provider informed us they were still not compliant with the regulations. The service is now no longer suspended and is able to operate.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Inspection areas

Safe

Updated 16 August 2017

We did not inspect the safe key question in full at this inspection. We inspected only those aspects mentioned in the notice of suspension dated 2 December 2016.

We found that all the required improvements had been made, for example:

  • There was now a policy in place for reporting and recording significant events. Staff had received training on significant events and understood their responsibilities.

  • There was now a system in place to receive and act upon patient safety and medicine alerts.

  • Safeguarding policies were easily accessible to staff and a flow chart was available for quick reference. All staff had received safeguarding training appropriate to their role and had an awareness of issues that might pose a risk.

  • Identity checks were now in place for patients ordering medicines and photographic ID was requested upon delivery of the medication.

Effective

Updated 16 August 2017

We did not inspect the effective key question in full at this inspection. We inspected only those aspects mentioned in the notice of suspension dated 2 December 2016.

We found that all the required improvements had been made, for example:

  • There was now a system in place to monitor prescribing to ensure it was in line with best practice and NICE guidelines.

  • The clinical system had been updated so that clinicians could easily access previous patient consultations, communication and prescriptions.

  • There was now a strategy in place to undertake audits.

    • Staff had received training relevant to their role and a training plan was in place.

Caring

Updated 16 August 2017

We did not inspect the caring key question at this inspection.

Responsive

Updated 16 August 2017

We did not inspect the responsive key question in full at this inspection. We inspected only those aspects mentioned in the notice of suspension dated 2 December 2016.

We found that all the required improvements had been made, for example:

  • Patient requests for medicine could now only be authorised or declined by a clinician.

  • A screen reader was in place for patients with sensory impairment to assist in accessing the website. 

  • Information on how to make a complaint was clearly listed on the website.

Well-led

Updated 16 August 2017

We did not inspect the well-led key question in full at this inspection. We inspected only those aspects mentioned in the notice of suspension dated 2 December 2016. We found that all the required improvements had been made, for example:

  • Staff now had an understanding of the statement of purpose and this was available to view on noticeboards.
  • There was now a supporting business plan in place that reflected the vision and values.
  • There were structured management and team meetings in place with a set agenda to cover important topics.
  • Policies and procedures were easily accessible on the intranet system.
  • There was now a clear leadership structure in place.