Background to this inspection
Updated
4 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
Unit 4 is part of Vocare Limited. This service provides a NHS 111 service for a population of approximately 900,000 patients in the Bath and North-East Somerset, Swindon and Wiltshire region. Since May 2018, the provider, Vocare, is sub-contracted to deliver the service as part of an Integrated Urgent Care service. They are accountable to the main contract holder Medvivo. Vocare deliver GP Out of Hours and urgent care services to more than 9.2 million patients nationally. (NHS 111 is a telephone based service where people are assessed, given advice and directed to a local service that most appropriately meets their needs).
We visited Unit 4 as part of our inspection. It operates 24 hours, 365 days a year from Greenways Business Park, Bellinger Close, Chippenham SN15 1BN. The location is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activity: Transport services, triage and medical advice provided remotely.
Approximately 70% of public contact to this service is handled by Vocare House, Balliol Business Park, Newcastle Upon Tyne NE12 8EW. This location is registered separately with the Care Quality Commission. We did not visit this as part of this inspection.
Updated
4 March 2019
This service is rated as Good overall.
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? – Good
We carried out an announced comprehensive inspection at Unit 4 on 21 January 2019 as part of our inspection programme.
At this inspection we found:
- The service had systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
- The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- The management and administrative system for recording the provider’s mandatory training was not up to date and indicated gaps in training completion. The service was unable to fully evidence training completion.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- Patients were able to access care and treatment from the service within an appropriate timescale for their needs. At times when service demand was high regional escalation plans were implemented and external organisations keep abreast of performance and risk.
- Views and experiences of people who used the service was limited. This meant they had limited opportunity to actively engage in shaping the service.
- There was a focus on continuous learning and improvement at all levels of the organisation. However, we found limited evidence to support testing of new learning was embedded.
The areas where the provider should make improvements are:
- Consider a formal system to demonstrate evidence of how learning from incidents and quality improvement work has been embedded and improved quality of care delivery.
- Continue to develop the programme of completed audits to identify impact on patient care.
- Systems to demonstrate completion of one to one monthly reviews and training records should be maintained for all staffing groups to enable oversight from the leadership team.
- Continue to improve opportunities to engage the views and experiences of service users including carers and people in a range of equality groups.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice