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Medicare Medical Services LLP Good Also known as Edmonton GP Walk-In Centre

Inspection Summary


Overall summary & rating

Good

Updated 14 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Medicare Medical Services LLP (also known as Edmonton GP Walk-In Centre) on 25 March 2017. The centre provides care for unregistered (walk-in) patients. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
  • Risks to patients were assessed and well managed.
  • Patients’ care needs were assessed and delivered in a timely way according to need.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • The service managed patients’ care and treatment in a timely way.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The service told us that its commissioners had only recently requested monthly performance monitoring reports but we did not see evidence that the staff had formally met to review these reports and to see where improvements to the service could be made.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The service was well equipped to treat patients and meet their needs. For example, we noted that the local area was relatively deprived and staff told us that many local people worked zero hour contracts which required attendance at work at short notice. Staff and patients spoke positively about how the service enabled flexible, non appointment based care to be provided which could accommodate patients’ employment commitments.

  • There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

  • Ensure that there are systems in place to ensure that the processes and policies for safeguarding vulnerable adults are kept up to date with latest guidance and legislation.

  • Ensure a copy of its Business Continuity Plan is stored off site.

  • Consider increasing the use of clinical audit, in order to drive quality improvements.

  • Consider developing a performance monitoring protocol to review and assess where improvements can be made; and to enable analyses of how long it takes to be seen at different times of the day.

  • Review its protocols to see how it can improve on the time taken for patients’ notes to be sent to their registered GP following a consultation.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 June 2017

The service is rated as good for providing safe services.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

  • There was an effective system in place for recording, reporting and learning from significant events.

  • Risks to patients were assessed and well managed.

  • Lessons were shared to make sure action was taken to improve safety in the service.

  • When things went wrong patients were informed in keeping with the Duty of Candour. They were given an explanation based on facts, an apology if appropriate and, wherever possible, a summary of learning from the event in the preferred method of communication by the patient. They were told about any actions to improve processes to prevent the same thing happening again.

  • The service had clearly defined and embedded system and processes in place to keep patients safe and safeguarded from abuse.

  • Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. However we found that some elements of the service’s vulnerable adults safeguarding policy did not reflect the latest legislation.

Effective

Good

Updated 14 June 2017

The service is rated as good for providing effective services.

  • The service told us that its commissioners had only recently requested monthly performance reports but we did not see evidence that the staff had formally met to review these reports and to see where improvements to the service could be made.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Clinicians provided care to walk-in patients based on current evidence based guidance.

  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 14 June 2017

The service is rated as good for providing caring services.

  • Patients fed back that they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

  • Information for patients about the services available was easy to understand and accessible.

  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 14 June 2017

The service is rated as good for providing responsive services.

  • Service staff reviewed the needs of its local population and engaged with its commissioners to secure improvements to services where these were identified. For example, the provider had recently been additionally commissioned to provide weekday evenings GP and nurse appointments as part of a local GP access initiative.

  • The service had good facilities and was well equipped to treat patients and meet their needs. For example, data indicated that the local area was relatively deprived and staff told us that many local people patients worked zero hour contracts which required attendance at work at short notice. Staff and patients spoke positively about how the walk in centre enabled flexible, non appointment based care to be provided which worked around patients’ employment commitments.

  • The service had systems in place to ensure patients received care and treatment in a timely way and according to the urgency of need.

  • Information about how to complain was available and easy to understand and evidence showed the service responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 14 June 2017

The service is rated as good for being well-led.

  • There was a clear leadership structure and staff felt supported by management.

  • There was a strong focus on continuous learning and improvement at all levels.

  • The service had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

  • The provider was aware of and complied with the requirements of the duty of candour. The provider encouraged a culture of openness and honesty. The service had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken.

  • The service proactively sought feedback from staff and patients, which it acted on.

  • The service had a number of policies and procedures to govern activity but some were not kept up to date.

  • There was also an overarching governance framework which supported the delivery of the strategy, of good quality care and of risk identification but we noted that formal performance monitoring had only recently been introduced.