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Archived: Mount Gould Local Care Centre Good

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Inspection Summary


Overall summary & rating

Good

Updated 15 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mount Gould Local Care Centre (also known as Sentinel Healthcare South West (Community Interest Company)) on Thursday 24 November 2016. For the purposes of this report Mount Gould Care Centre will be referred to as Sentinel Healthcare or the provider.

Overall Mount Gould Care centre (Sentinel Healthcare) 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 reporting and recording significant events.
  • Clinical risks to patients were assessed and well managed. Environmental and organisational risk assessments were being developed to ensure they identified and mitigated risk.
  • Governance processes were monitored on an annual cycle.Environmental health and safety and infection control processes were checked as services were used and monitored on an annual rolling programme.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Sentinel Healthcare used patient feedback, clinical audit, service reviews and significant incident report monitoring to monitor outcomes for patients. A Sentinel Healthcare quality account was provided each year which stated how the organisation would meet clinical effectiveness, patient satisfaction, promotion of self-care and how to manage complaints and significant events.

  • Sentinel Healthcare were working with Devon, Cornwall and Somerset Clinical Education Provider Network to provide an additional facility to ensure a consistent approach to safeguarding in the South West.

  • Sentinel Healthcare provided diabetic education to newly diagnosed insulin diabetic patients. This was provided by a multidisciplinary team of dieticians and nurses and in various locations to suit patient’s needs.
  • Sentinel Healthcare were communicating with external businesses and stakeholders to understand how they could help support better lifestyle options and reduced dependence on the NHS.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • 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.
  • Patients were complimentary about the service, staff and access to treatment.
  • Appointments were 20 minutes or longer if needed which benefitted patients with complex issues.

  • There was a clear leadership structure and staff felt supported by management.
  • Sentinel Healthcare 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.
  • Sentinel Healthcare had performed a review of care homes in Plymouth, West Devon and the South Hams to understand the diagnosis rates of residents with undiagnosed dementia. The results have been presented at a Parliamentary and CCG level and were currently shaping some of the way services will be commissioned in the future. Sentinel Healthcare had also worked with the Plymouth Dementia Action Alliance. As a result Sentinel Healthcare had been awarded a Dementia Action Alliance – Friendly City award – in recognition of their efforts.

The areas where the provider should make improvement are:

Continue to develop governance processes to more clearly identify, record and manage risks at all centres where clinical care and treatment is provided. For example further development of:

  • Systems to monitor medicines management, equipment safety, control of infection, and environmental health and safety in buildings not within control of the provider.

  • Systems to more formally record and report issues within the centres used.

Fully maintain induction records to demonstrate staff have received suitable support , appraisal and induction.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 15 February 2017

Sentinel Healthcare is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events

  • Lessons were shared to make sure action was taken to improve safety at Sentinel Healthcare.

  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.

  • The provider had clearly defined and embedded systems, processes and policies in place to keep patients safe and safeguarded from abuse.

  • Clinical risks to patients were assessed and well managed. However, due to the nature of the way the services were deivered services, some systems and processes for environmental and organisational risk assessments had not yet fully implemented to identify and mitigate risk in all locations where clinical care and treatment is provided. However, these were under development.

Effective

Good

Updated 15 February 2017

Sentinel Healthcare is rated as good for providing effective services.

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

  • The organisation used patient feedback and clinical audit to monitor the effectiveness of the service.

  • There was evidence of personal development plans for all staff. The majority of staff had received an appraisal and those that had not had a date booked for this to be completed.

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

  • Sentinel Healthcare had a contract with a nationally recognised supermarket to provide a ‘Tour’ of their Plymouth store to see how food labelling works and how patients could best utilise their shop to help optimise the management of their long term condition.

  • Sentinel Healthcare were working with Devon, Cornwall and Somerset Clinical Education Provider Network to provide an additional facility to ensure a consistent approach across to safeguarding in the South West.

Caring

Good

Updated 15 February 2017

Sentinel Healthcare is rated as good for providing caring services.

  • Data from surveys carried out by Sentinel Healthcare showed high patient satisfaction for several aspects of care. For example, patients said they felt Sentinel Healthcare offered an excellent service and staff were helpful, caring and treated them with dignity and respect.

  • Patients said 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 15 February 2017

Sentinel Healthcare is rated as good for providing responsive services.

  • Sentinel Healthcare staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.

  • Patient’s satisfaction about access to the service was positive.

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

Well-led

Good

Updated 15 February 2017

Sentinel Healthcare is rated as good for being well-led.

  • Sentinel Healthcare 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.

  • There was a clear leadership structure and staff felt supported by management. Sentinel Healthcare had a number of policies and procedures to govern activity and held regular governance meetings.

  • Some governance systems and processes, whilst in place, required further oversight and development to ensure opportunities to implement mitigating actions were routinely carried out

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

  • Sentinel Healthcare proactively sought feedback from staff and patients, which it acted on.

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