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Salisbury Walk-In Health Centre Good Also known as WilcoDoc

Inspection Summary


Overall summary & rating

Good

Updated 15 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive

inspection at Wilcodoc (also known as Salisbury Walk-In Centre) on 21 March

2017. The service provides an out of hours service. 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 been trained to provide them with the skills, knowledge and

    experience to deliver effective care and treatment.

  • There

    was a system in place that enabled staff access to patient records, and the out

    of hours staff provided other services, for example the local GP and hospital,

    with information following contact with patients as was appropriate.

  • 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.

  • The service worked proactively with other

    organisations and providers to develop services that supported alternatives to

    hospital admission where appropriate and improved the patient experience.

  • The service had good facilities and was well

    equipped to treat patients and meet their needs.

  • 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.

     

We saw one area of outstanding service:

  • The service worked closely with local GP

    practices and the clinical commissioning group to review the needs of its local

    population and to secure improvements to services where these were identified. We

    saw numerous examples of innovative service developments that had been proposed

    and implemented by the service to support local needs. For example, in response

    to an increase in the number of children attending the local accident and

    emergency unit with a minor illness and an increase in non-elective admissions,

    the service had worked with local GP practices and the local clinical

    commissioning group (CCG) to develop a specialist out-of-hours paediatric

    service that had reduced hospital attendance and admissions by this group of

    patients.

The areas where the provider should make improvement are: 

  • Review the need to assess the clinical needs of patients who may have to

    wait more than 30 minutes to be seen.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 15 May 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

  • 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 walk-in 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.

Effective

Good

Updated 15 May 2017

The service is rated as

good for providing effective services.

  • 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.

  • The service had conducted

    one audit of patient consultations in the last six months.

  • We saw evidence the service met most of nationally recognised standards

    for care. However the provider should ensure regular audits of patient

    consultations are carried out, and review the need to assess the clinical needs

    of patients who may have to wait more than 30 minutes to be seen.

Caring

Good

Updated 15 May 2017

The service is rated as

good for providing caring services.

  • Feedback from the large majority of patients through our comment cards

    and collected by the provider was very positive.

  • 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.

  • Patients were kept informed with regard to their care and treatment

    throughout their visit to the out-of-hours service.

Responsive

Good

Updated 15 May 2017

The service is rated as

good for providing responsive services.

  • The service worked closely with local GP practices and the clinical

    commissioning group to review the needs of its local population and to secure

    improvements to services where these were identified.

  • We saw numerous examples of innovative service developments that had

    been proposed and implemented by the service to support local needs.

  • The service had good facilities and was well equipped to treat patients

    and meet their needs.

  • 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. The service

    told us that following an audit of complaints they had identified that letters

    being sent to patients did not include information about how to escalate the

    complaint if the patient was not satisfied with the service’s response, in line

    with guidance from NHS England and the services own complaints policy. The service

    told us they had taken steps to address this and we saw evidence of this.

  • Learning from complaints was shared with staff and other stakeholders. 

Well-led

Good

Updated 15 May 2017

The service is rated as

good for being well-led.

  • 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.

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

    management. The service had a number of policies and procedures to govern

    activity and held regular governance meetings.

  • There was an overarching

    governance framework which supported the delivery of the strategy and good

    quality care. This included arrangements to monitor and improve quality and

    identify risk.

  • 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.