7 and 8 October 2018
During a routine inspection
This service is rated as good overall (previous inspection 04. 2018 – Inadequate).
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 on 22 and 23 April 2018. Our overall rating for the service was inadequate and following discussions with North Staffordshire and Stoke Clinical Commissioning Groups, Vocare and The Royal Stoke Hospital, the provision of the streaming service was transferred to hospital staff until the required improvements could be made. We rated the service to be inadequate for providing safe, effective and well-led services; requires improvement for providing responsive services and good for providing caring services. We served warning notices for breaches in relation to Regulation 12: Safe Care and Treatment and Regulation 17: Good Governance. The hospital management team agreed to provide the service on a temporary basis until the provider could re-commence provision of the service. The transfer of the service back to the Urgent Care Centre North Staffordshire was completed on 10 September 2018.
At this inspection we found:
- Systems to safeguard vulnerable patients had been strengthened.
- There was a consistent approach for identifying risks, issues and implementation of mitigating actions.
- Processes to manage risks relating to shared learning from significant events and incidents were being used effectively.
- Emergency equipment and medicines were easily accessible to staff.
- Staff employed had the appropriate skills to treat patients accepted into the service.
- There was suitable pain relief medicine to treat acute pain.
- Clinicians were working to clear exclusion criteria; no inappropriate patients were found to have been accepted into the service.
- Prescriptions were securely stored and an effective system was in place that monitored their use.
- Patients’ care needs were assessed and delivered in a timely way and according to need.
- Systems and processes had been improved to enable the provider to effectively assess, monitor and improve the quality and safety of the services provided.
- The governance arrangements had been strengthened and covered permanent and temporary staff 24 hours a day, seven days a week.
The area where the provider should make improvements are:
- Refresh training for staff on the use of smartcards when using the computer system.
I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice