Bradford Care Alliance CIC Also known as Bradford Care Alliance CIC Ltd

This service is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – requires improvement

Are services effective? – requires improvement

Are services caring? – good

Are services responsive? – good

Are services well-led? – requires improvement

Why we carried out this inspection

We carried out an announced comprehensive inspection at Bradford Care Alliance CIC as part of our inspection programme.

How we carried out the inspection

Throughout the pandemic the Care Quality Commission (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 staff interviews using video conferencing and telephone calls

• requesting evidence from the provider

• a site visit.

As part of this inspection we interviewed, by video conferencing or telephone calls, the Chief Operating Manager, the Service Development and Governance Officer, the Operational Delivery and Performance Manager, two reception staff, a physiotherapist, one nurse, a GP who worked within the primary care streaming service and the Corporate Director.

On the day of the inspection we interviewed the Medical Director, the Chair of the board, the Registered Manager, the Strategic Director, the Human Resource (HR)/ Finance and Operational Delivery Assistant, a GP working in the extended access service, a member of the reception team, a nurse and a healthcare assistant (HCA).

Our Findings:

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this provider as requires improvement overall and requires improvement for providing safe, effective and well-led services. We have rated the key questions of caring and responsive as good.

We found that:

• Whilst regular visits were undertaken to the hub sites, the provider could not evidence that the systems and processes in place enabled them to maintain appropriate or complete oversight of health and safety, fire or infection prevention and control for staff or patients at these sites.
• The provider did not have a system to monitor and maintain oversight of the staff working in the hub sites. The provider did not have oversight or evidence relating to the competencies, training, professional registration updates, vaccination status or disclosure and barring checks (DBS) for staff who were providing the regulated activities.
• The service had a clear process in place to manage complaints and significant events and we saw these were reviewed at several levels within the organisation. Whilst we saw that actions were taken and lessons learned, not all staff who we spoke with were aware of the outcomes or any learning arising from significant events and complaints. None of the complaints we reviewed contained information of how the lessons learned or changes made to services were discussed and disseminated to staff.
• Staff treated people with compassion, kindness, dignity and respect.
• Patient feedback was positive and reflected that patients were able to access care and treatment at a time to suit them. The service was described as helpful, caring and convenient.
• There was limited evidence of quality improvement, including clinical audit. The provider did not monitor the quality of the clinical interventions provided by staff. They did not offer appraisals, supervisions or provide regular meetings and updates to all staff.
• Patients were able to access care and treatment from the service within an appropriate and responsive timescale for their needs.
• There was a focus on continuous learning and improvement at senior management level. Leaders were committed to the vision and values of the organisation and were motivated to provide responsive care which met patient’s needs.

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

• Ensure that care and treatment is provided in a safe way for service users.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review their arrangements for communicating with staff regarding the named leads for organisational policies.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care