This service is rated as
Good
overall. (We previously inspected this service in April 2019 at which time the service was rated good overall and for all key questions).
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Outstanding
We carried out an announced comprehensive inspection at Zava (Health Bridge Ltd) on 23 January and 14 February 2023 as part of our inspection programme.
The Medical Director is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Our key findings were:
- The service had systems for sharing information with staff and other agencies to enable them to deliver safe care and treatment.
- There were effective protocols for verifying the identity of patients.
- The provider assessed needs and delivered care in line with relevant and current evidence-based guidance and standards.
- All staff were appropriately qualified. The provider had an induction programme for all newly appointed staff.
- The service gave patients timely support and information.
- Staff communicated with people in a way that they could understand.
- The provider understood the needs of their patients and improved services in response to those needs.
- Information about how to make a complaint or raise concerns was available.
- Leaders were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.
- Leaders at all levels were visible and approachable. They worked closely with staff and others to make sure they prioritised compassionate and inclusive leadership.
- The service only prescribed unlicensed medicines against valid special clinical needs of an individual patient and where there was no suitable licensed medicine available.
We saw the following areas of outstanding practice:
- Since 2011 the service had provided anyone who had created an account with the facility to ask health-related questions.
- Patients were not required to pay to access the messaging advice service. Nor were they required to have ever requested a paid service.
- Doctors working for the service responded to the questions within a maximum of 24 hours, and often much sooner.
- A recent audit found 36% of messages received were requests for free advice. Ten per cent of these messages were not related to prior paid services.
- During the Covid-19 pandemic (the pandemic), the service, in partnership with the Royal College of Physicians (RCP), developed a free online learning resource to support those adapting to remote consultations during the pandemic.
- The resource covered a range of information to support clinicians in understanding:
- What is digital healthcare?
- When is it appropriate to consider remote care?
- Types of digital healthcare.
- Logistics and setting up remote access.
- The key differences between face-to face and digital consultations?
- Learning and support in a remote setting
- The resource remained accessible via the RCP and YouTube. At the time of inspection the resource accessible via YouTube information had been viewed over 4200 times.
The areas where the provider should make improvements are:
- Ensure that clinicians seek corroborating monitoring evidence, such as up to date blood test results, when prescribing medicines for long-term conditions.
- Ensure that recommendations relating to risks identified in legionella risk assessments are addressed in a timely way.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services