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Inspection Summary


Overall summary & rating

Good

Updated 10 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Humber NHS Foundation Trust Out of Hours (OOH) services on the 22 April 2016. We reviewed the services at East Riding Community Hospital and Goole primary care centre where these services are based. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

  • All staff were encouraged and supported to record any incidents. There was evidence of good investigation, learning and sharing mechanisms in place.

  • There was a clear leadership structure and a stable workforce in place. Staff were aware of their roles and responsibilities and told us the GPs and managers were accessible and supportive.

  • Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • The primary care centre had excellent facilities and was well equipped to treat patients and meet their needs.
  • Vehicles used for home visits were clean, well maintained and equipped.
  • The practice had good facilities and was well equipped to treat and meet the needs of patients.

  • There was a complaints policy and clear information available for patients who wished to make a complaint.
  • The practice sought patient views how improvements could be made to the service, through the NHS Friends and Family Test.

  • The ethos of the practice was to deliver good patient centred care.

  • The service was aware of and complied with the requirements of the duty of candour (being open and transparent with people who use the service, in relation to care and treatment provided).

However, there were areas of practice where they should make improvements:

  • Review the provision of signage inviting patients to request a chaperone.

  • Review chaperone training for staff. .

  • Review the provision and signage re complaints and health information in the waiting areas of the OOH facility.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 10 August 2016

The practice is rated as good for providing safe services.

  • Risks to patients were assessed and well managed.

  • There was a nominated lead and systems in place for reporting and recording significant events. Lessons were shared to ensure action was taken to improve safety in the practice.

  • All staff were encouraged and supported to record any incidents.

  • Systems were in place to keep patients and staff safeguarded from abuse. There was a nominated lead in place for both safeguarding children and adults.

  • There were processes in place for safe medicines management.

  • GPs visiting patients in their home were accompanied by a driver, who stayed in the vehicle whilst the GP attended the patient.

  • Governance processes ensured that each call to the service was recorded and that patient records were updated correctly.

  • Vehicles used to take clinicians to patients’ homes for consultations were well maintained, cleaned and contained appropriate emergency medical equipment.

  • Emergency equipment held at the service locations was maintained and checked regularly

Effective

Good

Updated 10 August 2016

The practice is rated as good for providing effective services.

  • 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.

  • There was evidence of clinical audit, clinical supervision and reflective feedback processes for all clinical staff to ensure the delivery of high quality patient care.

  • Staff received training relevant to their roles and were up to date with all mandatory training.

  • The service worked closely with patients’ own GPs and information was shared with the out of hour’s service.

Caring

Good

Updated 10 August 2016

The practice is rated as good for providing caring services.

  • The practice had a strong patient-centred culture and we observed that staff treated patients with kindness, dignity, respect and compassion.

  • 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 at all times.

  • Chaperones were available for those patients who requested one however we noted that the signage was omitted from the waiting area and consultation rooms. We also noted that key staff did not have chaperone training.

Responsive

Good

Updated 10 August 2016

The practice is rated as good for providing responsive services.

  • The provider undertook continuous engagement with patients to gather feedback and held patient and public involvement events to source suggestions for improvements. Changes were considered to the way it delivered services as a consequence of this feedback. Patient satisfaction, patient safety, friends and family test results and Healthwatch information were also discussed.
  • The service understood the needs of the population it served and engaged with local Clinical Commissioning Groups to provide services that were responsive to the needs of the population.
  • Plans were developed by the patient’s GP and shared with the out of hours GP service for clinically high demand patients including patients with long term conditions and complex health needs. Special notes were used to record relevant information about patients.
  • Information about how to make a complaint if you were unhappy with the service and how to access PALS (Patients Advice Liaison Service) information was available on the web site and via leaflets in the main area of the hospital. However we found this could be improved in the OOH waiting area.

Well-led

Good

Updated 10 August 2016

The practice is rated as good for being well-led.

  • There was a clear leadership structure and a vision and strategy to deliver high quality care and promote good outcomes for patients.

  • There were governance arrangements which included monitoring and improving quality, identification of risk, policies and procedures to minimise risk and support delivery of quality care.

  • The provider was aware of and complied with the requirements of the duty of candour (being open and transparent with people who use the service, in relation to care and treatment provided). There were systems in place for being aware of notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken.

  • There was a strong focus on continuous learning and improvement at all levels, staff were encouraged to continually learn and develop their skills.

Other CQC inspections of services

Community & mental health inspection reports for Willerby Hill can be found at Humber Teaching NHS Foundation Trust.