Archived: West Midlands Doctors Urgent Care - Wolverhampton Urgent Care Centre

This service is rated as Good overall. (Previous inspection February 2018 – Requires Improvement overall, however the practice was rated inadequate for providing effective services and remained in special measures).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We previously carried out an announced comprehensive inspection at West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on 21 March 2017 as part of our regulatory functions. The service was rated as inadequate overall. The full comprehensive report for the March 2017 inspection can be found by selecting the 'all reports' link for West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on our website at www.cqc.org.uk .

An announced focused inspection was carried out at West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre (WUCC) on 26 October 2017 to confirm that the service had taken appropriate action to meet the legal requirements in relation to the warning notices issued in July 2017. You can read the follow up inspection report, by selecting the 'all reports' link for West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on our website at www.cqc.org.uk . 

A further announced comprehensive inspection was carried out at WUCC on 6 February 2018 and 27 February 2018 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 at our previous inspections on 21 March 2017 and to follow up on concerns received. The full comprehensive report for the February 2018 inspection can be found by selecting the 'all reports' link for West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on our website at www.cqc.org.uk .

This inspection was an announced comprehensive inspection carried out on 8 November 2018 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 at our previous inspection in February 2018. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• Systems had been introduced to manage safety alerts. Risks to patients were assessed and well managed, particularly in relation to ensuring sufficient staff were available to meet surges in demand.
• The service had significantly improved their performance of the National Quality Requirements.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• Patients’ care needs were assessed and delivered in a timely way and according to need. An effective triage system had been implemented and all staff had received training to ensure a consistent practice.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were maintained and well equipped.
• There was a clear leadership structure and staff felt supported and valued members of the team.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The provider was aware of and complied with the requirements of the duty of candour.

There were areas where the provider should continue to make improvements:

• Ensure continued action is taken to achieve the National Quality Requirements performance indicators.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service’

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This service is rated as requires improvement overall. (Previous inspection March 2017 – Inadequate)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? – Requires Improvement

We previously carried out an announced comprehensive inspection at West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on 21 March 2017 as part of our regulatory functions. The service was rated as inadequate overall. The full comprehensive report for the March 2017 inspection can be found by selecting the 'all reports' link for West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on our website at www.cqc.org.uk.

An announced focused inspection was carried out at West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on 26 October 2017 to confirm that the service had taken appropriate action to meet the legal requirements in relation to the warning notices issued in July 2017. You can read the follow up inspection report, by selecting the 'all reports' link for West Midlands Doctors Urgent Care – Wolverhampton Urgent Care Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 6 February 2018 and 27 February 2018 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 at our previous inspection on 21 March 2017 and to follow up on concerns received. 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 an open and transparent approach to safety and systems were in place for recording and reporting significant events. An effective process to share learning with staff had been implemented.
• Systems had been introduced to manage safety alerts.
• Risks to patients were assessed but not always well managed, particularly in relation to ensuring sufficient staff were available to meet surges in demand.
• Patients’ care needs were assessed but not always delivered in a timely way and according to need. For example, there was a potential risk where walk-in patients and children were not clinically triaged in a timely manner and many patients waited for long periods to be seen.
• The service met the National Quality Requirements in some areas however, there was evidence of performance being below the required targets.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were maintained and well equipped.
• There was a clear leadership structure and staff generally felt supported by the management team.
• The provider was aware of and complied with the requirements of the duty of candour.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.
• Ensure effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

For details, please refer to the requirement notices at the end of this report.

In addition the provider should:

• Ensure training and procedures for dealing with emergencies are reviewed.

This service was placed in special measures in July 2017. Insufficient improvements have been made and there remains a rating of inadequate for one key question. Therefore, we are taking in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice