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Archived: Blossoms Healthcare LLP- Tooley Street Good

We are carrying out a review of quality at Blossoms Healthcare LLP- Tooley Street. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 16 May 2019

During a routine inspection

This service is rated as Good overall. (Previous inspection February 2018, prior to ratings programme)

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 an announced comprehensive inspection at Blossoms Healthcare Tooley Street on 16 May 2019 as part of our inspection programme.

The provider supplies private general practitioner services predominantly to staff working at four large corporate organisations. The provider also provides services to private fee-paying patients.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Blossoms Healthcare Tooley Street approximately 90% of patients are treated under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, we were only able to rate the services which are not arranged for patients by their employers. However, some of the evidence quoted in the report regarding the quality of fee-paying patient outside of this exemption stems from evidence of care provided to exempt patients as this was used to demonstrate the general quality of care provided to all patients using the service.

The provider is in the process of registering a new registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 23 CQC comments cards. All comment cards were positive with patients referring to the high standard of care provided by knowledgeable and supportive staff.

Our key findings were:

  • The provider had systems in place to keep people safe and to review, act and learn from significant events. We reviewed examples where the provider had made contact with the patient’s NHS GP to pass on information that was clinically necessary with the patient’s consent. We were told that, when necessary to ensure patient safety, the service would contact the patients NHS GP without consent. However records reviewed showed that the provider did not consistently keep records of patient’s NHS GP details. The provider told us after our inspection that it was now mandatory for new patients to provide the details of their NHS General Practitioner and that all existing patients who had not provided this information previously would be asked to provide it when they attend their next appointment.
  • There were processes in place to effectively handle emergencies and risks were managed appropriately. Most appropriate recruitment checks had been completed for the staff whose files we reviewed. However, references had not been taken or retained for one healthcare assistant.
  • Systems were in place for the safe management of medicines and we saw that the provider had processes in place to review prescribing. However, the provider was not undertaking regular reviews of antibiotic prescribing.
  • Staff at the service assessed patients in accordance with best practice and current guidelines and had systems in place to monitor and improve the quality of care provided to patients.
  • There was evidence of effective joint working and sufficient staffing to meet the needs of their patient population.
  • Feedback indicated that patients were treated with dignity and care and the service had systems to support patients to be involved with decision about their care and treatment.

  • The service met the needs of their targeted patient demographic and there were systems in place for acting on feedback and complaints.
  • The service had adequate leadership and governance in place.
  • There was clear strategy and vision which was tailored to patient need and staff and patients were able to engage and feedback to the service provider.

The areas where the provider should make improvements are:

  • Obtain and retain references for all staff recruited
  • Implement policies around obtaining patient’s NHS GP details prior to consultation.
  • Review antibiotic prescribing to assess the extent to which the service is following best practice and guidance.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 20 February 2018

During a routine inspection

We carried out an announced comprehensive inspection on 20 February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The provider supplies private general practitioner services.

Dr Lianne De Maar is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We reviewed 40 CQC patient comment cards, 37 of which were exclusively positive about the service provided. The comment cards stated that staff were caring and considerate and appointments were easy and convenient to access. Negative comments included suggestions from one patient that some tests provided by the service might be unnecessary and one patient stated that they did not always feel listened to.

Our key findings were:

  • There was a system in place for acting on significant events.
  • Risks were generally well managed though mechanisms for ensuring that urgent test results and patient safety alerts were actioned were insufficient.
  • There were arrangements in place to protect children and vulnerable adults for abuse.
  • Staff had received essential training and adequate recruitment and monitoring information was held for staff.
  • Care and treatment was provided in accordance with current guidelines.
  • Patient feedback indicated that staff were respectful and caring and appointments were easily accessible.
  • The practice responded to patient complaints in line with their policy.
  • There was a clear vision and strategy and staff spoke of an open and supportive culture. There was effective governance in most areas to ensure risks were addressed and patients were kept safe.

There were areas where the provider could make improvements and should:

  • Implement systems to ensure urgent referrals are followed up and clinicians are alerted of safeguarding concerns when accessing clinical records.
  • Draft policies which reflect variations at each site.