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Inspection Summary


Overall summary & rating

Good

Updated 1 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Walk in Centre, Dewsbury and District Hospital on 23 February 2017. The overall rating for the service was requires improvement and a breach of the legal requirements was found. The full comprehensive report for the February 2017 inspection can be found by selecting the ‘all reports’ link for Walk in Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17 October 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 23 February 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the service is now rated as good.

Our key findings were as follows:

  • The provider had implemented a system to assure themselves that all the appropriate checks were carried out by the employing agency on locum staff.
  • The provider demonstrated quality improvement activity.
  • The provider had taken steps to reduce risks to patients within the Walk in Centre by working to clarify arrangements and responsibilities for the monitoring and management of equipment and the environment.
  • The service had decided not to see or treat children under two years of age until a protocol for the management of this age group was agreed with Mid Yorks Hospitals Trust (MYHT). We were shown evidence that work to achieve this protocol was underway. All staff we spoke with were aware of this and children were directed to the emergency department.

In addition the provider should:

  • Continue to work with Mid Yorks Hospitals Trust to ensure the reduction of risks to patients through the continued review and formulation of written protocols and agreements for the area.
  • Review their arrangements for carrying out fire drills in conjunction with Mid Yorkshire Hospital Trust in line with Government guidelines.
  • Deliver on their plan to carry out a patient satisfaction survey in November 2017.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 1 November 2017

This inspection was conducted to review issues that were found at the comprehensive inspection carried out on 23 February 2017. The issues at the previous inspection included:

  • The provider could not assure themselves that locums from the agency were DBS checked or had suitable professional indemnity arrangements in place.
  • We found a lack of written protocols and agreements between the Walk in Centre and Mid Yorks Hospitals Trust (MYHT) which clarified the arrangements and the responsibility for the assessment, monitoring and management of the area and the reduction of risks to patient safety.
  • The service could not evidence a policy or a risk assessment which detailed the types and amounts of high risk medications that were agreed as appropriate for clinicians to prescribe.

At this inspection in October 2017 we found:

  • The provider had implemented a system to assure themselves that all the appropriate checks were carried out by the employing agency on locum staff.
  • The provider had taken steps to reduce risks to patients within the Walk in Centre by working with MYHT to clarify arrangements and responsibilities for the monitoring and management of equipment and the environment.
  • Staff were clear that all prescribing was undertaken following a thorough assessment of the individual, their notes, previous history, clinical need and ongoing presentation. A quarterly audit of prescribing data was taking place; this was reviewed by the senior management team, including the medicines management lead. We were told appropriate action would be taken if individual clinicians’ prescribing patterns were found to be abnormally high.

Effective

Good

Updated 1 November 2017

Caring

Good

Updated 1 November 2017

Responsive

Good

Updated 1 November 2017

Well-led

Good

Updated 1 November 2017

This inspection was conducted to review issues that were found at the comprehensive inspection carried out on 23 February 2017. The issues at the previous inspection included:

  • The provider was not able to demonstrate clinical audits and assure themselves that they had considered the quality of care provided, reviewed the care provided in relation to best practice guidance and made changes where necessary in order to improve.

At this inspection in October 2017 we found:

  • We saw that audits were taking place and that there were plans for these to be repeated. We saw that action was taken following audits. For example, following a wound care audit the service was reviewing a best practice template with specialist nursing staff for use at the Walk in Centre