The Care Quality Commission
  • Doctor
  • Urgent care service or mobile doctor

Archived: Croydon Urgent Care Centre

Overall: Requires improvement read more about inspection ratings

530 London Road, Thornton Heath, Surrey, CR7 7YE (020) 3170 6369

Provided and run by:
Virgin Care Wandle LLP

All Inspections

17 June 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Croydon Urgent Care Centre on 17 June 2015. Overall the practice is rated requires improvement.

Specifically, we found the service to require improvement for providing safe, effective and well led services. It was good for providing caring and responsive services. The provider operates an out of hours service from the same location which was not inspected during this visit.

Our key findings were as follows:

  • Patients said they were treated with respect and did not raise concerns regarding privacy. However the reception and waiting area is open so conversations can be overheard and while treatment rooms have curtains, they provide minimal privacy;
  • Patients were generally happy with the care and treatment they received, although they were not always satisfied with the time they had to wait to receive treatment;
  • Information about how to make a complaint was available to patients and suitable arrangements were in place to deal with complaints;
  • The provider and the centre had systems in place to seek feedback from patients about the services it provided;
  • The urgent care centre is open 24 hours a day 365 days a year and accessible to all who attended;
  • Staff understood their responsibility to raise concerns and report incidents, although there were limited opportunities for meetings to discuss learning;
  • While audits had been carried out there was not a completed cycle and they did not demonstrate improvements made;
  • The service had developed a range of policies and procedures to govern activity, although some staff reported they did not have good access to them;
  • Staff recruitment practices were generally in line with requirements;
  • New staff received an induction to ensure they had the information they needed to carry out their role;
  • Systems were in place for staff to receive annual appraisals.

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

Importantly, the provider must:

  • Ensure the process for reporting and recording incidents is improved so the system is accessible to all staff and that lessons learnt are discussed and shared with relevant staff;
  • Ensure GPs are trained to the required Level in child protection;
  • Ensure a record is maintained of the fridge temperatures on a daily basis;
  • Ensure the details of any cancelled prescriptions are recorded in line with the provider’s policy and guidance;
  • Ensure there are clear and effective systems in place to assess, monitor, mitigate risks and improve the quality and safety of the service through the completion of clinical audit cycles, learning from incidents and complaints and engaging with staff.

In addition the provider should:

  • Look at ways to improve privacy for patients, at reception and in treatment areas;
  • Ensure staff record checks made of clinical trolleys and any actions required or taken;
  • Be able to assure themselves that those tasks being carried out by hospital trust staff are being done to the appropriate standard. This included cleaning of communal areas and testing of electronic equipment;
  • Continue to recruit to vacant staff posts to reduce the reliance on locum staff;
  • Consider providing specific training for staff relevant to working in an urgent care centre.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

21, 22 July 2014

During an inspection looking at part of the service

We noted improvements since our last visit in September 2013 and found that people were now given appropriate information regarding the services available. They were assessed appropriately and their care was delivered based on national guidance. The provider worked with other professionals to ensure people received safe care. Staff received induction, training and support and the provider had systems in place to ensure that the quality of the service was regularly monitored.

It should be noted that the streaming model adopted by the local CCG and implemented by the provider was quite unique to the location. At this stage, there is a lack of evidence to demonstrate whether this innovative approach is as safe and effective as other models of care. However, from the evidence we saw, the system, as it is currently operated, appeared to be safe and working effectively.

The premises however, do not adequately meet the needs of patients and staff. It should be noted that the provider does not own the premises (these are owned and run by the Croydon Health Services NHS Trust). However, all providers are required to operate out of suitable premises irrespective of whether or not they own them. Since our last visit, improvements had been made and there were plans for refurbishment, although these required final approval and the project had not commenced at the time of our visit.

20 September 2013

During an inspection in response to concerns

At the last inspection on 15th and 16th July 2013 we found that the provider was not meeting the essential standards of quality and safety under three regulations. The service did not give appropriate information and support in relation to patient's care and treatment. There were problems with the design and suitability of the premises and we had concerns about how the provider worked with the Emergency Department of Croydon University Hospital. We also found that patients were streamed for treatment by non-clinical reception staff. We were concerned that there was a risk of a patient with a serious illness or injury being wrongly streamed and their condition deteriorating.

During our recent inspection of Croydon University Hospital further concerns were raised by the public and health professionals about Croydon Urgent Care Centre (CUCC). We carried out a responsive inspection at the service on the 20th September 2013.

We spoke with patients who used the service. We observed the waiting area and we spoke with three receptionists and three clinicians as well as the registered manager at CUCC.

We noted the same concerns about the streaming policy that we found at the previous inspection. We found that aspects of the streaming policy were not being implemented. We were concerned that people might be at risk because of delays in clinical assessment.

We had concerns about the training offered to non-clinical staff to support them with streaming and with the systems to assess and monitor the streaming process.

The provider recognised the need for improvements as a result of the July inspection and provided the Care Quality Commission with an action plan about how improvements would be made. The action plan was not in place at the time of the September inspection.

15, 16 July 2013

During a routine inspection

People told us that they were satisfied with the treatment they received. One person told us, "The staff are really nice." Another person said, "It's been okay so far." Some people told us that they were not told how long they would be waiting or given information about what would happen after being booked in at reception. One person told us that they had waited a long time but the nurse who treated them was, "Great." Another person told us, "You would think there would be a screen advising you of waiting times."

We found that people were not being given appropriate information and support in relation to their care and treatment. We also found that patients were streamed for treatment by non-clinical reception staff. We were concerned that there was a risk of a patient with a serious illness or injury being wrongly streamed and their condition deteriorating. The streaming has been taking place since October 2012 and although no such incident has been reported we were concerned about the risk that it could happen.

There were problems with the design and suitability of the premises. The layout of the treatment area did not guarantee the privacy and dignity of people and other areas were in need of refurbishment or improvement.

We found that there were enough qualified, skilled and experienced staff to meet people's needs. There was also an effective complaints system in place and complaints were responded to appropriately.

6 February 2013

During a routine inspection

People told us the staff were caring and helpful and that the service was efficient. One person said "its first class you couldn't better it". Staff were observed to be discreet when registering people for treatment. We observed people were registered and treated promptly.

Peoples privacy and dignity were observed during consultation and treatment. People told us they had had their test results and proposed treatment explained to them. They said they had been given information to take home with them about their condition and after care. We saw the information provided was up to date and contained details of treatment options available and how people could obtain further information and advice if required.

The premises were well maintained, clean, warm and equipped to investigate and provide treatment to adults and children for minor injuries and non urgent conditions. Appropriate standards of cleanliness and hygiene were maintained to safely provide treatment and care to people and minimise the risk of infection.

Staff were trained to ensure they had the skills to identify safeguarding issues and act upon them. We saw that processes were in place to monitor and manage risks to people who use or work in the service.