Archived: NICS at The Red Practice

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? – Inadequate

We carried out an announced comprehensive inspection at North West Surrey Integrated Care Services NICS Ltd as part of our inspection programme. This was the first inspection of this improved access service. Our inspection included visits to offices where some of the service administrative staff were based and the five locations where the service operated. This report relates to our findings of the service as a whole and the specific findings relating to The Red Practice location.

Our key findings were:

• Patients were supported and treated with dignity and respect. Services were offered weekday evenings and Saturday mornings from five hub locations across the area covered by the 38 practices of the federation, ensuring the service was accessible to all patients.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• Care and treatment was delivered according to evidence-based guidelines.
• Patients found the appointment system easy to use and reported they were able to access care when they needed it.
• The federation had reviewed the needs of their local population and ensured that additional services were offered. For example, cervical cytology screening, wound care and phlebotomy services.

However, we also found that:

• The service had not ensured care and treatment was always provided in a safe way to patients.
• The service was unable to assure themselves that people received effective care and treatment.
• The leadership and governance of the service did not ensure the delivery of high-quality care.
• The service could not evidence that all the checks required to employ staff appropriately were in place.
• We found that policies and procedures were not always written and shared with staff to govern activity and ensure staff were adhering to the same processes.
• The service did not have systems and processes to give assurance that staff would raise, share and record all significant events. There was a lack of evidence to demonstrate that any identified learning was shared with the whole service team.
• The service did not always have sufficient oversight of the premises from where they delivered services. For example, the service had not reviewed premises management information sent from the host sites and had not followed up areas of non-compliance, so were unaware if the host sites had rectified problems found.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure staff who are suitably qualified, competent, skilled and experienced persons, are deployed to meet the fundamental standards of care and treatment.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

The areas where the provider should make improvements:

• Review and improve the documentation of verbal complaints.

Dr Rosie Benneyworth BM BS BMedSci MRCGP Chief

Inspector of Primary Medical Services and Integrated Care