We carried out an announced comprehensive inspection on 19 March 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?
Our findings were:
Are services safe?
We found that this service was providing safe care in accordance with the relevant regulations
Are services effective?
We found that this service was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this service was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this service was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this service was providing well-led care in accordance with the relevant regulations.
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, Bupa Centre-Leeds, was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
Bupa Centre-Leeds offers a range of health assessments, GP services, musculoskeletal services, dermatology services and minor surgery. Physiotherapy services are also available at the location. These services are provided by GPs, health advisors and other healthcare specialists. The service is open Monday to Friday. Patients can book an appointment via the telephone or on-line. However, the service does not provide care to children or young people under the age of 18.
The Bupa Centre-Leeds, refers to individuals who use their service as customers and this is reflected throughout the report.
This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Bupa Centre-Leeds, some services are provided to customers under arrangements made by their employer, a government department or an insurance company with whom the service user holds a policy. These types of arrangements are exempt by law from CQC regulation. Therefore, at Bupa Centre-Leeds, we were only able to inspect the services which are not arranged for customers by above mentioned parties.
The centre manager 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.
As part of our inspection we asked for Care Quality Commission comment cards to be completed by patients prior to our inspection. Forty seven comment cards were completed, 44 of which were overwhelmingly positive about the service provided. The service was described as excellent or very good and the staff were described as professional and friendly. Of the three cards which contained less positive comments, one person commented on improvements which could be made to the environment and two customers stated the service did not meet their expectations. We also reviewed a comments book which was available in the customer waiting area. During the two months prior to our visit, 21 comments had been made, all of which described a professional, informative and caring service.
Our key findings were:
- The centre had a clear protocol in place for the management of safety alerts. These were disseminated to the staff team and reviewed and managed at a local and organisational level. A ‘Clinical Effectiveness’ bulletin was also available which updated clinicians on the latest guidelines, medicines and device approvals, published studies and articles of interest from the past month.
- Staff enjoyed working at the centre and felt very supported by the centre manager, the clinical team and the clear systems and processes of the organisation.
- There was an infection prevention and control audit in place with completed actions. We saw evidence that cleaning schedules were thorough and completed to a high standard.
- The centre conducted regular quality improvement activity and audits. This included the review of notes, clinicians’ consultations and prescribing. The centre also participated in benchmarking activities with other Bupa services.
- Feedback from customers highlighted that staff treated customers with kindness and respect and they felt involved in decisions and treatment plans.
- Information about how to complain was available and evidence showed the centre responded quickly to any concerns raised. Learning from complaints was shared widely within the team and at a provider level.
- The vision and values of the organisation were embedded into the team. Staff discussed these with each other and with us on the day of inspection. They detailed how the values enabled them to give excellent customer service and supported them to speak out when things went wrong.
There were areas where the provider could make improvements are:
- Review and improve the registration process of customers to confirm their age and identity.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice