27 November 2018
During an inspection looking at part of the service
We carried out an announced focused inspection on 27 November 2018 to ask the service the following key questions - Are services safe?
Our findings were:
Are services safe?
We found that this service was providing safe care in accordance with the relevant regulations.
We had previously inspected the service on 8 January 2018 and found that the service was not providing safe care and treatment in accordance with Regulation 12 of the Health and Social Care Act 2008.
We carried out this inspection to check whether the service had made improvements and was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
The full comprehensive report on the January 2018 inspection can be found at: www.cqc.org.uk/location/1-4287806730.
The service provides an independent GP, travel clinic and mental health service. 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 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 Newcastle Premier Health, the majority of services provided are occupational and vocational health assessments and services to patients under arrangements made by their employer and other organisations. They also provide private aesthetic cosmetic treatments. These types of services are exempt by law from CQC regulation. Therefore, at Newcastle Premier Health, we were only able to inspect the services that fall within the scope of regulation under the Health and Social Care Act.
n January 2018, we noted quality improvement and clinical audit activity had focused on the occupational health aspect of the business. The provider had planned to develop their approach to encompass the area within the scope of regulation under the Health and Social Care Act to support them to improve patient outcomes. In November 2018, we found the service had made good progress with implementing this. They planned to carry out three audits a year to check the quality of the service offered and so far, had carried out audits of the:
- Infection prevention and control arrangements;
- Prescribing arrangements;
- Travel vaccination service. In particular, this checked the patient group directions (PGDs) implemented following the last CQC inspection. (PGDs are the legal framework by which nursing staff who are not prescribers are authorised to administer or supply medicines.)
These were single cycle audits, but each audit indicated a planned appropriate timescale in which to complete the audit cycle to check on the improvements made.
Our key findings were:
- The service had improved systems to keep people safe and safeguarded from abuse. This included clarity on the role of chaperones, embedding infection prevention and control policies and checking the level of safeguarding training clinicians had received.
- The service had implemented patient group directions to legally authorise nursing staff who were not prescribers to administer or supply specified medicines.
- The service had reviewed the emergency medicines they held to treat patients in a medical emergency and now held supplies in line with national guidance or had in place a valid risk assessment to show why a recommended medicine was not required.
- The service had not yet improved their approach to learning and making improvements as a result of patient and medicine safety alerts. However, they had started to implement arrangements which would support a clear audit trail of prescribed medicines to support them to identify and take action to protect patients who may be at risk as identified by patient safety and medicine alerts.
There was an area where the provider could make improvements and should:
- Review the process for managing patient safety and medicine alerts so there is a systematic process for identifying and taking action to protect patients who may be at risk.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice