Background to this inspection
Updated
3 February 2020
The service is provided by BB Healthcare Solutions Ltd from satellite locations. The extended access service rotates around a set number of GP practices. This service is provided from 6.30pm to 8pm, Monday to Friday, 8am to 6pm on Saturdays and 9am to 2pm on Sundays and public holidays. The premises that this service is provided from are used by a separate provider prior to 6.30pm on weekdays.
The extended hours service provided for a small number of GP practices is also based in premises that are used by a separate provider prior to 6.30pm. The hours for this service are Wednesdays 6.30pm to 10pm and Thursdays 6.30pm to 9pm.
The acute home visiting service is provided across the Basildon and Brentwood CCG area. All three services are booked through the patient’s usual GP.
How we inspected this service
Prior to this inspection, we spoke with stakeholders and reviewed a range of information that we hold about the service.
During the inspection we:
- Visited the administrative base for the provider and also one of the locations used as an extended access hub.
- Reviewed systems and documents relating to the governance of the service.
- Explored how clinical decisions were made and how these were relayed to the patients usual GP.
- Observed staff interactions with patients
- Talked to people using the service and their relatives
- Spoke with a range of staff.
- Reviewed CQC comment cards which included feedback from patients about their experiences of the service.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
3 February 2020
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 Head Office as part of our inspection programme.
The Head Office location is where BB Healthcare Solutions Ltd has a permanent office. They offer the following services:
- Extended hours services, for the GP practices in two out of the six local primary care networks.
- They provide extended access services for all the GP practices in Basildon, Billericay and Wickford, in evenings and at weekends.
- They provide acute home visiting services, within core hours, across the Basildon and Brentwood CCG area.
The Medical Director for the provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
61 people provided feedback about the service. People told us that staff were friendly, helpful and caring. They told us that they felt listened to and treated with dignity and respect. All feedback we received was positive about the service offered.
Our key findings were:
- There were effective safeguarding systems in place.
- The service did not have records of immunity status of some staff.
- There were effective systems in place for the management of medicines and prescription stationery.
- Emergency medicines and equipment were being stored. However, not all items recommended in national guidance were kept and there was no risk assessment to inform this. The service rectified this soon after our inspection.
- There were arrangements in place for the risk assessment and maintenance of facilities and equipment used. Although, the services had access to these records via the GP practices, they did not always keep copies of these risk assessments. This was rectified the day after our inspection.
- Staff had access to clinicians and managers when working. Staff competency assessments were present in staff files viewed.
- Care and treatment was provided in line with best practice guidelines.
- There were policies and procedures in place for staff accessible through a shared drive.
- The service had a programme of audit. Outcomes were used to improve the service provided.
- We saw that staff treated patients with dignity and respect and this was evident in feedback we received from patients.
- Staff told us that they felt supported and able to raise concerns.
- There were systems in place to develop staff.
- There was a clear leadership and governance structure in place.
The areas where the provider should make improvements are:
- Review and record the immunisation status of all relevant staff.
Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care