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STADN Limited Requires improvement

This service was previously registered at a different address - see old profile


Inspection carried out on 10 and 11 September 2019

During a routine inspection

Letter from the Chief Inspector of General Practice

We rated this service as Requires improvement overall. The location had not previously been inspected.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Not sufficient evidence to rate

Are services caring? – Not sufficient evidence to rate

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at STADN Limited over two days on 10 and 11 September 2019 as part of our inspection programme.

STADN Limited was established in 2006 and registered with the Care Quality Commission in 2014. It is run by two directors who are based at the management offices. It currently provides a remote clinical advice service delivered by doctors via telephone. It had recently stopped providing video consultation services.

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 general 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 STADN Limited, some services are provided to patients under arrangements made by their employer, by an insurance provider with whom the service user holds an insurance policy (other than a standard health insurance policy). STADN Limited also provides: remote clinical advice to other medical professionals without consulting with their patients directly, remote clinical advice to providers who are based and treat patients overseas; clinical and call handling solutions for other health care organisations including NHS commissioners. These types of arrangements are exempt by law from CQC regulation. Therefore, at STADN Limited, we were only able to inspect the services which are provided in England and not arranged for patients by their employers or an insurance provider with whom the patient holds a policy.

At this inspection we found:

•The provider had not notified CQC of a change of address and had not ensured CQC was provided with accurate contact details for the registered manager and nominated individual.

•The provider did not require clinicians to make written notes of calls to the telephone advice service and did not have a process in place to manage any notes produced.

•Arrangements in place to oversee the secure storage of recordings of calls made to the service were not effective.

•The provider had separate prescribing policies for the different services provided but it was not clear which policy applied to each service. The service was not undertaking any prescribing activity at the time of this inspection.

•Doctors were trained to deliver the service in a way that respected privacy and dignity.

The area where the provider must make improvement is:

•Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The area where the provider should make improvement is:

•Review systems used to manage personnel records to ensure managers can be assured all required pre-employment checks are in place and required mandatory training is up to date.

•Put a system in place to document home working risk assessments undertaken by staff working remotely, to ensure their working environment is safe.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care