Archived: Urgent Care Centre (Paulton)

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Urgent Care Centre, Paulton on 28 February and 1 March 2017 The overall rating for the service was requires improvement. The full comprehensive report on the 28 February and 1 March 2017 inspection can be found by selecting the ‘all reports’ link for Urgent Care Centre, Paulton on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 December 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 28 February and 1 March 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the service remains rated as Requires Improvement

Our key findings were as follows:

• Systems for logging checks of medicines and equipment had been implemented. We found that medicines were in date and that equipment had been appropriately calibrated.

• Communication and management support for staff had improved.

• Not all staff had received chaperone training and management were unaware of this.

• Not all staff had received performance appraisals.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that systems and processes are established and operating effectively to support good governance.

• Ensure that staff have received appropriate training and appraisal.

In addition the provider should:

• Ensure that equipment and medicine checking logs encompass all relevant information in order to support staff appropriately.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Urgent Care Centre, Paulton on 28 February and 1 March 2017. Overall the service is rated as requires improvement.

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.
• Patient's care needs were assessed and delivered in a timely way according to need. The service had difficulties meeting two of the national quality requirements and had completed remedial action plans to improve this in November 2016.
• Staff assessed patient's 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. However, not all staff that chaperoned had received adequate training.
• There was a system that enabled staff to access patient records, and the out-of-hours staff provided other services, for example the local GPs and hospital, with information following contact with patients as was appropriate.
• The service managed patient's care and treatment in a timely way. However, this service was often centralised to the Royal United Hospital (RUH) in Bath, due to a lack of GP cover. This ensured the patients clinical need was met although some patients had further to travel.
• 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. The vehicles used for home visits were clean and well equipped. Clinical equipment that required calibration was calibrated according to the manufacturer’s guidance. However, the equipment in the bag for the vehicle had not been calibrated.
• There was a leadership structure, however, some members of staff informed us that they did not feel supported by local management at the RUH and felt isolated at Paulton.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Establish and operate an effective system to check, manage and mitigate the risks associated with the emergency equipment and medicines. Ensure that all equipment is calibrated in line with manufacturers guidance or replaced when necessary.

• The provider must undertake and record appraisals or performance reviews for all staff members every 12 months.

• Ensure that all staff receive training specific to their roles, such as chaperone training.

The areas where the provider should make improvement are:

• Ensure that Paulton staff are supported by a visible management team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice