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Archived: SELDOC OOHs at Kingston Hospital Good

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Reports


Inspection carried out on 21/05/2018

During an inspection to make sure that the improvements required had been made

This service is rated as Good overall. The service was previously inspected by the CQC on 3 August 2017. At that inspection the rating for the service was good overall. This rating applied to effective, caring, responsive and well led and all six population groups. Safe was rated as requires improvement.

The report stated where the service must make improvements:

  • Develop effective systems and processes to ensure safe care and treatment including ensuring the proper and safe management of medicines, and assessing the risk of not providing Oxygen and Automatic External Defibrillator on service vehicles used for home visits and, where appropriate, mitigate their absence.

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 carried out a focused inspection of the SELDOC Out of Hours Service at Kingston Hospital on 21 May (visiting both the hub centre and the main site). The focussed inspection was to check if areas within the safe domain which were in breach of CQC regulations were now resolved

At this inspection we found:

  • Cars used by the service had Oxygen and an Automatic External Defibrillator available for use.
  • The service utilised prescriptions where GPs provided medications to patients directly in line with guidance.
  • The service had implemented new systems for how medicines were supplied to the site. Stocks were monitored and relevant drugs were available.
  • Medicines audits had been completed and the service showed improved antibiotic prescribing following audits.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Inspection carried out on 3 August 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the SELDOC Out of Hours Service at Kingston Hospital on 3 August 2017. Overall the service is rated as good.

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

  • The arrangements for managing medicines at the service did not always keep patients safe. Medicines audits had been introduced but were not yet completed, with one cycle being carried out, and as such did not demonstrate actions identified had been implemented or were effective in making improvements in prescribing and medicines management. The provider did not record the dispensing of medicines in line with guidelines.
  • The service did not carry medical gases such as Oxygen, or an Automatic External Defibrillator (AED) in vehicles used for home visits and did not have a documented risk assessment mitigating their absence.
  • There were clearly defined and embedded systems and processes in place to keep patients safe and safeguarded from abuse.
  • There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
  • Patients’ care needs were assessed and delivered in line with current evidence based guidance and in a timely way according to need. The service met the National Quality Requirements.
  • 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 local GPs and hospital, with information following contact with patients as was appropriate.
  • 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.
  • 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.

The areas where the provider must make improvement are:

  • Ensure care and treatment is provided in a safe way for service users; including the proper and safe management of medicines and assessing the risk of not providing Oxygen and Automatic External Defibrillator on service vehicles used for home visits and, where appropriate, mitigating their absence.  

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice