Background to this inspection
Updated
19 June 2019
The service is provided by Multimed Ltd and located at Ascroft Medical, 3 Ascroft Court, Peter Street, Oldham, OL111HP. The service provides dental and medical services to children and adults. The website address is https://www.ascroftmedical.co.uk/.
The regular team consisted of:
•Five dentists one of whom was responsible for having oversight of the dental care provided at the service.
•Two dental hygienists.
•Two dental nurses.
•Seven doctors.
•One registered nurse.
•One phlebotomist.
The doctors, dentists and other health care professionals are supported by the registered manager and a team of administration and reception staff.
Patients are primarily Polish people with English as a second language. Patients are self-referring and there are no geographical boundaries to using the service. The service is accessed through pre-booked appointments. The practice is open on demand seven days a week.
How we inspected this service
We inspected this service through reviewing policies, documents, reports and systems used to support staff in providing the service; observation of the interactions between staff and patients and the staff teams; interviews with members of the clinical and administrative staff and senior manager; review of notifications and information received about the service from independent sources; information published on social media sites. The provider also submitted information requested prior the site visit and during the inspection.
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
19 June 2019
This service is rated as Good overall. (Previous inspection 25/05/2018)
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 Ascroft Medical as part of our inspection programme.
Ascroft Medical is registered with the Care Quality Commission (CQC) as an independent provider of dental and medical services for children and adults and is in Oldham, Greater Manchester. Patients are primarily of Polish descent or Polish speaking people. Patients are self-referring and there are no geographical boundaries to using the service. The service is accessed through pre-booked appointments.
The service is registered with the CQC to provide the following regulated activities:
•Diagnostic and screening procedures;
•Surgical procedures;
•Treatment of disease disorder and injury;
•Midwifery and maternity.
The service employs doctors, dentists and dental nurses on a sessional basis. A full range of dental care and treatment including dental implants and extractions, is provided at the service.
Medical services made up approximately 20% of the business and services include: gynaecology; diagnosing and treating adult illnesses and diseases; dermatology; treatment of ear, nose and throat conditions; childhood immunisation; blood tests; cytology smear tests and pre and postnatal health checks.
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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Ascroft Medical provides a range of non-surgical cosmetic interventions, for example Botox injections and dermal fillers which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.
The registered 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.
We found that patients were positive about the medical and dental care and treatment provided by the service. Feedback was provided by 6 patients and their comments indicated that they trusted the clinicians; staff treated them with respect and consideration; they felt involved in their care and the consulting rooms and waiting areas were clean and pleasant to use.
Our key findings were:
•Action taken by the provider and systems in place protected people from avoidable harm and abuse in relation to: safeguarding vulnerable children and adults; dealing with safety alerts; most aspects of health and safety and medicines management.
•Some aspects of medicines management, water safety-checks and indemnity cover for doctors however, needed to be reviewed.
•Action taken by the provider was effective in ensuring care, treatment and support was provided in keeping with best practice guidance so as to provide good outcomes for patients.
•The provider ensured the facilities promoted the privacy of patients and staff treated patients with respect and kindness. The provider participated in local charitable causes.
•Action taken by the provider and processes in place meant services provided were responsive to people’s needs for example, care and treatment was person-centred and complaints and concerns were responded to appropriately.
•Governance arrangements in relation to administrative systems; the dental provision and aspects of medical care which overlapped with dentistry such as medicines management were well organised and sufficient to support sustained and good quality care. The monitoring and oversight of medical services were not reviewed and monitored separately.
•The information collected about performance had not as yet been analysed to identify trends or to track performance against a set of standards.
•The provider did not effectively review staff compliance with their employment contract.
The areas where the provider should make improvements are:
•Review the services plan for first line treatment of sepsis in relation to best practice guidance.
•Strengthen the policies and procedure in relation to the level of indemnity insurance it requires clinicians and nurses to ensure consistency and provide assurance that the amounts are in keeping with best practice guidance.
•Review medicines audits to include whether a rational has been documented if treatment deviates from best practice guidance.
Review the policy in relation the competencies needed to carry out specific health and safety checks.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care