Background to this inspection
Updated
19 August 2019
Our inspection team was led by a CQC lead inspector.The team included a CQC GP specialist advisor.
Blossoms Healthcare LLP Garlick Hill is located at 21 Garlick Hill, London, EC4V 2AU and occupies the basement floor of a well maintained office building. The provider, Blossoms Healthcare LLP is part of an international healthcare organisation, HCA Healthcare Limited. This service is one of three separately registered locations operating under the Blossoms Healthcare brand name.
The service treats between 200 and 500 patients per week. The service predominantly provides services to the staff of large corporate clients. The service told us over 90% of their custom comes from these clients with under 10% from private individuals. The service did not consult with children.
The service delivers GP services, health assessments and occupational health advice. Patients can be referred to other services for diagnostic imaging and specialist care. Blossoms Healthcare staff work across all three locations and currently employs 11 GPs, 15 other clinical staff including physiotherapists, healthcare assistants and nurses, and 20 non-clinical staff. The service typically has four private doctors, two healthcare assistants and three receptionists assigned to this location.
The provider is registered with the Care Quality Commission (CQC) for the regulated activities of Treatment of Disease Disorder or Injury, and Diagnostic & Screening Procedures.
We carried out this inspection on 27 June 2019. The inspection was led by a CQC inspector and a GP specialist advisor.
Before visiting, we looked at a range of information that we hold about the service. We reviewed the last inspection report from February 2018 and information submitted by the service in response to our provider information request. During our visit we interviewed staff (two GPs; a chief nursing officer, the head of human resources and reviewed documents.
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?
Updated
19 August 2019
This service is rated as Good overall. The service was previously inspected in February 2018 and found to be meeting requirements for all domains.
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 Blossoms Healthcare – Garlick Hill on 27 June 2019 as part of our inspection programme.
The provider supplies private general practitioner services predominantly to staff employed by corporate clients. The provider also provides services to private fee-paying patients.
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 general 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 Blossoms Healthcare Garlick Hill, approximately 90% of patients are treated under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, we were only able to rate the services which are not arranged for patients by their employers. However, some of the evidence quoted in the report regarding the quality of fee-paying patient outside of this exemption stems from evidence of care provided to exempt patients as this was used to demonstrate the general quality of care provided to all patients using the service.
The provider is in the process of registering a new 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.
We received 12 CQC comments cards. All comment cards were positive with patients referring to the high standard of care provided by knowledgeable and supportive staff.
Our key findings were:
- The provider had systems in place to keep people safe and to review, act and learn from significant events. We reviewed examples where the provider had made contact with the patient’s NHS GP to pass on information that was clinically necessary with the patient’s consent. We were told that, when necessary to ensure patient safety, the service would contact the patients NHS GP without consent.
- There were processes in place to effectively handle emergencies and risks were managed appropriately. Recruitment checks had been completed for the staff whose files we reviewed.
- Systems were in place for the safe management of medicines and we saw the provider had processes in place to review prescribing. Following a recent inspection at another of it’s registered locations, the provider had developed plans to undertake regular reviews of antibiotic prescribing.
- Staff at the service assessed patients in accordance with best practice and current guidelines and had systems in place to monitor and improve the quality of care provided to patients.
- There was evidence of effective joint working and sufficient staffing to meet the needs of their patient population.
- Feedback indicated patients were treated with dignity and care and the service had systems to support patients to be involved with decisions about their care and treatment.
- The service met the needs of their targeted patient demographic and there were systems in place for acting on feedback and complaints.
- The service had adequate leadership and governance in place.
- There was clear strategy and vision which was tailored to patient need and staff and patients were able to engage and feedback to the service provider.
The areas where the provider should make improvements are:
- Follow through with plans to review antibiotic prescribing to assess the extent to which the service is following best practice and guidance.
- Continue to review and assess emergency medicines kept on the premises to ensure decisions are justified and reflect the treatments provided and the patient groups who use the service.
Dr Rosie Benneyworth BM BS BMedSci MRCGP Chief Inspector of Primary Medical Services and Integrated Care