At this follow up inspection, we carried out checks to ensure the provider had met their action plan.
We found there were substantial improvements in the arrangement of quality assurance systems in place. The systems now ensured that there were appropriate medication checks, staff training and appraisals and adequate record keeping in place to ensure a safer service for patients.
We visited the head office of the service so we were not able to speak directly with patients. The surgery is carried out in a number of clinics across the North West. We were shown surveys that patients completed and we saw that there was a high level of satisfaction with the service. Most patients were happy with the care that they received. Their comments included; 'The staff are fantastic. They make you feel at ease'; 'The entire process was very quick and well organised' and 'I am very pleased with the care received.'
At out last inspection we found that the service was not compliant with standards relating to supporting workers and the quality of records. At this inspection we found that some progress had been made but these two standards were still not being fully met.
At this inspection we found that patients were involved in decisions about their care and treatment and that their care was carried out effectively. We looked at the way that medicines were managed within the service and discussed with the registered manager the ways the system could be improved.
We also found that there were some gaps in the processes for monitoring the quality of the service provided. We have asked the service to take action about this.
We were unable to speak to patients at the time of inspection. However we looked at completed satisfaction surveys which demonstrated overall satisfaction with the service. Comments made included:
'Very professional",
'It's all good' and
'Nursing staff were fantastic'.
We found that patients were properly cared for and treated with dignity and respect. Consent was obtained appropriately and by suitably qualified and experienced staff.
We found that staff had access to relevant guidance and information and had received suitable training in respect of safeguarding of vulnerable adults and children.
Complaints were dealt with appropriately on an individual basis, however they were not logged and analysed to identify trends. Evidence was found that outcomes of complaints were communicated to the staff via written memos and meeting minutes.
We found that staff training and supervision had not been fully implemented according to plans. We found clinical staff had received some appropriate training in relation to core topics relevant to their roles; however administration staff had not received sufficient relevant training.
We found improvements were needed in relation to accuracy of records and record keeping.