- SERVICE PROVIDER
Central and North West London NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 27 April 2026
Contents
Ratings - Community urgent care service
Our view of the service
This was the first assessment of this service. We rated the service as Good. This service is run by Central and North West London NHS Foundation Trust.
The Camden urgent community response (UCR) service provides urgent nursing or therapy input to patients aged 18 and over living in Camden in order to avoid an unnecessary hospital admission. Patients were seen at home, in residential care or nursing homes. Patients were triaged as requiring either an urgent response within two hours or an urgent response over two hours, depending on clinical need. The service operates between 8am-10pm, seven days a week, with a referral cut-off time of 8pm.
We carried out this assessment due to concerns raised to the CQC about the service. The concerns related to incidents where a patient had deteriorated and/or died whilst using the service as well as overall service safety and processes relating to how the service functioned. Additional concerns were also raised internally, including issues relating to clinical practice, the culture of the service, and working relationships between staff groups.
In response to the cultural concerns raised, the trust held listening events and carried out a review of the service in 2024. The review included meeting with staff across different professional groups. The review led to recommendations aimed at strengthening governance, clarifying processes, and promoting psychological safety, which were subsequently implemented.
In response to clinical and governance concerns, the trust implemented a rapid access service steering group to consider and oversee the safety and quality of clinical provision as well as operational and governance systems. This steering group identified actions needed to assess the concerns and implemented changes to improve the service. Actions taken included commissioning a thematic review of the service and serious incidents, and the creation of a specific rapid access service manager role. Workstreams were created to deliver any necessary changes. During this inspection we saw that recommendations had been implemented to improve the service.
The thematic review of the service took place between 2024 and 2025 and identified areas of practice which needed to be improved. One area was in the escalation of physical health deterioration and better use of NEWS2, which is used to quickly assess how unwell a patient is by scoring their vital signs and triggering an appropriate clinical response. Other areas identified for improvement were in triage and screening, staff communication, documentation, staffing, end of life planning and capacity and consent practices. Three workstreams were introduced to implement the recommendations. One workstream focussed on frameworks and policies and reviewed and implemented changes to the service’s standard and local operating procedures. One workstream was an autonomy of practice group to reinforce roles and responsibilities of staff. The final workstream, the workforce group, reviewed recruitment, retention, wellbeing and the learning and development of staff.
We assessed the Camden urgent care response service from 30 January 2026 to 4 February 2026. We undertook a site visit on 30 January 2026 and carried out further offsite activities on 4 February 2026.
We inspected 33 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas to give the rating of good.
Mental Capacity Act Compliance
The service identified as part of the thematic review that assessing and recording mental capacity assessments could be improved within the patient records. The service had taken steps to improve this by providing face to face Mental Capacity Act training, which included documenting mental capacity assessments on patient records.
Staff could describe and knew how to get accurate advice on the Mental Capacity Act and this formed part of their mandatory training. At the time of our assessment, 96% of staff had completed their Mental Capacity Act training.
Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. Staff took all practical steps to enable patients to make their own decisions.
For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.
Staff audited the application of the Mental Capacity Act within the monthly documentation audits and acted on any learning that resulted from it.
People's experience of this service
We spoke with 4 patients and carers, all of whom expressed positive feedback about using the service. Patients said staff treated them with kindness, dignity and respect.
Staff enabled patients to give feedback on the service they received. Patients and carers gave feedback through the friends and families test. At the time of our assessment, this was at 91.8% from 50 responses obtained within the last 12 months. Staff collected and shared compliments received by the service. The service had received 42 compliments in the last 12 months.
During our assessment we observed a home visit. Staff discussed the potential care and treatment options with a patient. The patient was supported to choose a decision that was right for them.
Patients told us:
“Staff were very experienced, professional and caring in nature.”
“Staff were quick to respond, treated me with respect and were very understanding.”
“I can honestly say that they treated me just as I would like to be treated and exactly as I would treat someone myself.”
“The team went out of their way to ensure that I was aware of what was happening and what would happen after they stopped coming. I know they kept my daughter updated too.”
“I was very impressed by how quickly they were able to get things done the same day or within 24 hours that normally took weeks.”
Carers told us:
“None of the professionals attending could have been more caring or compassionate towards mum and myself in what was a worrying time.”
“I received calls at least every other day, sometimes more than once a day to keep me updated on what was happening.”