Archived: Pacific House

Updated 15 June 2021

Pacific House is the administrative and management base for services provided by East Sussex Outpatient Services. East Sussex Outpatient Services (ESOPS) is an independent provider of consultant-led NHS commissioned outpatient services. The Registered Provider is East Sussex Outpatient Services Ltd.

Services are provided from:

Pacific House, 1 Easter Island Place, Eastbourne, East Sussex, BN23 6FA.

Clinical outpatient services are provided from a neighbouring host location at:

Harbour Medical Centre, 1 Pacific Drive, Eastbourne BN23 6DW.

Opening times are Monday to Friday 9am to 5pm.

Services are provided by specialist consultants who are employed on a sessional basis to provide outpatient consultation and diagnostic services in a range of specialties which include, gynaecology, Ear, Nose and Throat (ENT), musculoskeletal (MSK), urology, colorectal, ophthalmology, gastroenterology and general surgery. Two nurses and a healthcare assistant provide support to those outpatient services. Services are managed by a team of five directors and an office manager, who are supported by administration and reception staff. Administration staff are located at both Pacific House and Harbour Medical Centre and some staff work across both sites.

The service works closely with local referring GP services who refer patients for outpatient consultation, diagnostic and treatment services. Patients requiring treatment are referred onwards to local secondary care providers.

Updated 15 June 2021

We carried out a focused inspection of Pacific House (East Sussex Outpatient Services Ltd) on 12 February 2021 in response to concerns about the safe care and treatment of patients and governance arrangements within the service. We found breaches of regulations and took enforcement action. We issued warning notices against Regulation 12 (Safe care and treatment) Regulation 17 (Good governance) and Regulation 18 (Staffing), of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We carried out this inspection of Pacific House to confirm that the service now met the legal requirements in relation to those breaches of regulations and to ensure sufficient improvement had been made. This report only covers findings in relation to those requirements. The service was not rated as a consequence of this inspection.

Throughout the COVID-19 pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting remote and face-to-face interviews with staff.
• Reviewing patient records and patient tracking processes to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

We conducted a remote review of patient records on 11 May 2021 and carried out an announced site visit on 13 May 2021. Prior to our site visit on 13 May 2021 we requested supporting evidence and documents from the provider which we reviewed remotely.

Pacific House is the administrative and management base for services provided by East Sussex Outpatient Services Ltd. East Sussex Outpatient Services (ESOPS) is an independent provider of consultant-led NHS commissioned outpatient services. Clinical outpatient services are provided from a neighbouring host location at Harbour Medical Centre, 1 Pacific Drive, Eastbourne BN23 6DW. This location is not a registered location under ESOPS’s registration with the Care Quality Commission (CQC).

The service is registered with CQC to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening services.

The medical director is the registered manager. A registered manager is a person who is registered with CQC 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.

Our key findings were:

• There were processes for reviewing patients who may be subject to delays in treatment. However, these required further embedding, review and audit to ensure their efficacy.
• Systems for the reporting, review and recording of significant events had been improved.
• Staff had received updated guidance to ensure their awareness of the safeguarding lead and procedures they would follow if they had a safeguarding concern.
• Infection prevention and control auditing processes had been introduced. However, an action plan/log of findings was still required. Cleaning logs had been established in clinical rooms.
• There were clear processes in place to minimise risks associated with Covid-19 with regard to screening patients attending for appointments. However individual staff risk assessments and support arrangements associated with Covid-19 had not been documented.
• Processes for cleaning and decontamination of devices were more clearly defined. There were improved systems to ensure decontamination of devices was adequately documented. These processes required further embedding, review and auditing.
• There were improvements in the management of training for administrative staff. Staff had received training in key areas. Processes introduced to monitor training undertaken by clinical staff employed on a sessional basis were incomplete.
• Systems had been introduced to establish monitoring and oversight of clinical staff employed on a sessional basis. Consultants had been given access to organisational policies.
• There were improved processes for responding to verbal complaints which ensured these were recorded to assist with review, audit and learning.
• A structure of formal team meetings and improved processes for sharing information, guidance and learning with staff had been introduced.
• Staff found leaders approachable and supportive and were keen to contribute to individual and organisational improvements.
• Review of organisational policies was still underway and some required further revision. Staff had access to multiple versions of the same policy in some instances.
• Monitoring processes, to provide assurance to leaders that premises they were leasing were safe and suitable for use, were not clearly defined.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Continue to review and develop organisational policies to ensure staff have access to up-to-date guidance.
• Develop an action plan and log to monitor outcomes of infection prevention and control audit findings.
• Establish review of training and development needs of staff as part of annual review processes.
• Review and update staff COVID-19 risk assessments as individual needs and guidance change.
• Establish data sharing agreements with referring GP practices.
• Establish arrangements to share and review actions and learning from complaints and significant events as a whole staff team.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care